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Abstract
Sixty anterior cruciate Dacron prosthetic ligaments were placed arthroscopically in
57 patients from 1983 to 1985. Fifty-five of the 57 patients were followed for an
average of 4.4 years. The complication rate at 13 months was 29%; at 4.4 years, 43%.
There were 34 reoperations. In 16 knees (28%) the prosthesis had to be removed due
to abrasion and arthritis with rupture of the prosthesis. Thirteen knees had chronic
synovitis and one knee had bacterial infection, all of which were managed with arthroscopic
debridement. Four knees required removal of the extraarticular staple. Clinical testing
in 42 knees with the Dacron prosthesis still in place showed the Lysholm score improved
from a preoperative score of 43 points to a score of 82 points after 5 years. Of the
knees, 58% had a pivot shift of 2+−3+: a trace pivot shift in 30%; a negative pivot
shift in only 12%. The KT-1000 arthrometer verified those pivot shifts. The results
of this study are discouraging. The procedure was complicated by a high reoperation
rate, usually secondary to arthritis. The impression was that although stability of
the knee was improved by use of an artificial anterior cruciate ligament, the end
result of the therapeutic procedure was the development of an iatrogenic model of
degenerative arthritis in the human knee.
Keywords
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© 1992 Arthroscopy Association of North America. Published by Elsevier Inc.
