[Chronic anterior and internal instabilities of the knee. Treatment]

The effective treatment of antero-medial instability aims to restore mobility which contra-indicates a long post-operative period of plaster cast immobilisation and a passive repair of the ligaments. Satisfactory techniques allow early mobilisation without the use of a plaster cast. They are difficult to perform and need precision. Lesions at the upper end of the medial ligament are best treated by a plastic procedure using the gracilis and lesions of the lower end by use of the semi tendinosus. It is particularly important to determine the precise position of the upper insertion of the medial ligament, to determine the ideal tension of the released ligaments and capsule, to fix the tendons through the bone and to avoid any plaster immobilisation. Walking without weight-bearing is allowed until the fifteenth day. The time off work was about 60 days. The results were satisfactory provided that the lesions were not too old and there were no lesions of the articular cartilage. Associated meniscus lesions were treated by partial resection or repair by suture.