Primary surgical treatment of anterior cruciate ligament lesions

Seventy patients who underwent primary repair of the anterior cruciate ligament are reviewed in follow-up. The surgical technique consisted of multiple loop-varying depth sutures in both cruciate stumps in 61 patients. Nine patients had additional fascial augmentation done primarily. follow-up was from 12 to 90 months, the average being 29 months. All patients were scored on a 50-point normal knee score sheet. Average score at follow-up was 42.7. No patient was bothered by giving way, which is defined as an unpredictable instability. No patient has required subsequent meniscal surgery. Ninety-three percent of the patients were active in sports. Anterior drawer sign at 90 degrees showed increased excursion compared to the unaffected leg in all patients. However, Lachman's test showed a firm end point to excursion in all knees tested, and, in addition, 52% were rated as normal compared to the unaffected knee. We conclude that primary repairs of mid-substance tears are technically possible and recommended in an athlete.