Bone-block iliotibial-band transfer for anterior cruciate insufficiency

The anterior distal part of the iliotibial trace with attached bone block from Gerdy's tubercle was used as an intra-articular graft fixed by a screw to the tibia to control anterior instability (otherwise known as anterior, anteromedial, or anterolateral laxity) in twenty-four knees which were followed for two to four years. Concomitant single-plane 2+ to 4+ medial instability was present in eleven knees and was treated in five of them by simple immobilization, by imbrication of the medial collateral ligament, or by the Vigliani procedure. At follow-up, stability was improved and the result was rated good or excellent in twenty-one (88 per cent) of the twenty-four knees. The operation is applicable to the majority of chronic laxities of the knee and, because no immobilization is necessary, the postoperative care is much simplified and the rehabilitation time is much shorter. The procedure is contraindicated where there is posterior or single-plane lateral laxity.