[Is suture of the ruptured anterior cruciate ligament without augmentation sensible?]

The five- and ten-years review of 40 patients with primary suture of the anterior cruciate ligament without augmentation showed all patients to have a positive Lachman-Test. Five years postoperatively 14 patients had no complaints, after ten years, only two patients remained free of symptoms. Five years after suture nine patients were limited at work, while after ten years this number had risen to twelve. Ten years after the suture only eleven patients had the same sporting abilities as before the accident; only six patients retained their level of performance. Six patients needed a meniscus-operation between the first and second review (five and ten years postoperatively). Radiologically we found signs of gonarthrosis in 15% at five years and 30% at ten years. 75% of the patients with gonarthrosis had had partial meniscectomy. Our results confirm that instability caused by an insufficient anterior cruciate ligament leads to higher incidence of meniscal tears and osteoarthritis. A primary suture of the anterior cruciate ligament without augmentation almost always leads to functional instability. This surgical procedure therefore is not recommended.