Skip to main content
SpringerLink
Log in

Comparison of augmented and non-augmented anterior cruciate ligament reconstruction combined with high tibial osteotomy

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

In a follow-up study 27 patients were evaluated after anterior cruciate ligament (ACL-)reconstruction combined with high tibial osteotomy because of chronic rupture of the ACL, cartilaginous lesions of the medial compartment and varus malalignment. They were divided into two groups. In 14 patients (non-LAD group) ACL reconstruction was performed using the central third of the autologous patellar tendon modified according to Eriksson-Trillat. Thirteen patients (LAD group) underwent repair with the same technique, but a Kennedy ligament augmentation device (LAD) in ‘hot dog’ technique and fixed over the top was added. The postoperative treatment was the same in both groups. All patients were examined according to IKDC criteria. KT-1000 arthrometer testing at maximum manual traction was performed. Although the mean follow-up interval was more than double in the non-LAD group (non-LAD: 127 months vs LAD: 58 months), the subjective and clinical results, IKDC evaluation and KT-1000 arthrometer testing results were similar, showing no statistically significant difference. Further, no complications due to the use of LAD occurred. In this study no evident functional or clinical advantage from the augmentation performed could be shown.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Amoros Barcelo PJ, Marin Navarro M, Cabot Dalamau J, et al (1994) Etude critique de la plastie de Kennedy-LAD. Acta Orthop Belg 60: 145–151

    Google Scholar 

  2. Arnoczky SP, Torzilli PA, Warren RF, et al (1988) Biologic fixation of ligament prostheses and augmentations. An evaluation of bone ingrowth in the dog. Am J Sports Med 16: 106–112

    Google Scholar 

  3. Bach BR, Warren RF, Flynn WM, et al (1990) Arthrometric evaluation of knees that have a torn anterior cruciate ligament. J Bone Joint Surg [Am] 72: 1299–1306

    Google Scholar 

  4. Barrett G, Field L (1993) Comparison of patella tendon versus patella tendon/Kennedy LAD for anterior cruciate ligament reconstruction: study of results, morbidity and complications. Arthroscopy 9: 624–632

    Google Scholar 

  5. Bosch U, Kasperczyk W, Deckeer B, et al (1996) Morphologische Aspekte der alloplastischen Augmentation beim Ersatz des hinteren Kreuzbandes. Unfallchirurg 99: 183–190

    Google Scholar 

  6. Boss A, Stutz G, Oursin C, Gächter A (1995) Anterior cruciate ligament reconstruction combined with valgus tibial osteotomy. Knee Surg Sports Traumatol Arthroscopy 3:187–191

    Google Scholar 

  7. Butler DL, Grood ES, Noyes FR, et al (1989) Mechanical properties of primate vascularized vs. non-vascularized patellar tendon grafts; changes over time. J Orthop Res 7: 68–79

    Google Scholar 

  8. Cabaud HE, Feagin JA, Rodkey WG (1980) Acute anterior eruciate ligament injury and augmented repair. Experimental studies. Am J Sports Med 8: 395–401

    Google Scholar 

  9. Clancy WG, Narechania RG, Rosenberg TD, et al (1981) Anterior and posterior cruciate ligament reconstruction in rhesus monkeys. A histological, microangiographic, and biomechanical analysis. J Bone Joint Surg [Am] 6: 1270–1284

    Google Scholar 

  10. Conteduca F, Ferretti A, Mariani PP (1989) LAD augmentation of semitendinosus and gracilis in ACL reconstruction. Surgical technique and preliminary results (abstract). Am J Sports Med 17: 709–710

    Google Scholar 

  11. Curtis RJ, Delee JC, Drez DJ Jr (1985) Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs. A preliminary report. Am J Sports Med 13: 408–414

    Google Scholar 

  12. Dahlstedt L, Dalen N, Jonsson U (1990) Goretex prosthetic ligament vs. Kennedy ligament augmentation device in an anterior cruciate ligament reconstruction. A prospective randomized 3-year follow-up of 41 cases. Acta Orthop Scand 61: 217–224

    Google Scholar 

  13. Daniels DL, Malcolm LL, Losse G (1985) Instrumented measurement of anterior laxity of the knee. J Bone Joint Surg [Am] 67: 720–726

    Google Scholar 

  14. Engebretsen L, Benum P, Fasting O, et al (1990) A prospective randomised study of three surgical techniques for treatment of acute ruptures of the anterior cruciate ligament. Am J Sports Med 18: 585–590

    Google Scholar 

  15. Fowler PJ, Amendola A (1990) Allograft ACL reconstruction in a sheep model—the effect of synthetic augmentation. Trans Orthop Res Soc 15: 80

    Google Scholar 

  16. Fowler PJ, Capra SW (1991) Anterior cruciate ligament reconstruction with the Kennedy ligament augmentation device. In: Scott WN (ed) Ligament and extensor mechanism injuries of the knee. Mosby-Year Book, St Louis, pp 301–310

    Google Scholar 

  17. Gachter A (1992) Anterior cruciate ligament reconstruction through a transligamentous approach. In: Jakob RP, Stäubli HU (eds) The knee and the cruciate ligaments, anatomy, biomechanics, clinical aspects, reconstruction, complications, rehabilitation. Springer, Berlin Heidelberg New York, pp 384–388

    Google Scholar 

  18. Goertzen M, Dellmann A, Gruber J, Clahsen H, Burrig KF (1993) Homologous cruciate ligament transplantation as intraarticular ligament replacement. Z Orthop 131: 179–186

    Google Scholar 

  19. Gomez-Castresana FB, Bastos MN, Sacristan CG (1992) Semitendinosus Kennedy ligament augmentation device anterior ligament reconstruction. Clin Orthop 283: 21–33

    Google Scholar 

  20. Hanley P, Lew WD, Lewis JL, Hunter RE, Kirstukas S, Kowalczyk C (1989) Load sharing and graft forces in anterior cruciate ligament reconstructions with the ligament augmentation device. Am J Sports Med 17: 414–422

    Google Scholar 

  21. Hefti F, Müller W (1993) Heutiger Stand der Evaluation von Kniebandläsionen. Orthopäde 22: 351–362

    Google Scholar 

  22. Jackson DW, Grood ES, Arnoczky SP, Butler DL, Simon TM (1987) Cruciate reconstruction using freeze dried anterior cruciate ligament allograft and a ligament augmentation device (LAD). Am J Sports Med 15: 528–538

    Google Scholar 

  23. Kannus P, Järvinen M (1989) Posttraumatic anterior cruciate ligament insufficiency as a cause of osteoarthritis in a knee joint. Clin Rheumatol 8: 251–260

    Google Scholar 

  24. Kasperczyk WJ, Bosch U, Oestern HJ, et al (1994) Die Biomechanik des heilenden autogenen Patellarsehnentransplantates und die Bedeutung der Augmentation. Hefte Unfallchirurg 234: 98–135

    Google Scholar 

  25. Kennedy JC (1983) Application of prosthesis to anterior cruciate ligament reconstruction and repair. Clin Orthop 172: 125–128

    Google Scholar 

  26. Kennedy JC, Roth JH, Schmidt AA (1980) The ligament augmentation device (L.A.D.) in the anterior cruciate deficient knee. Orthop Trans 4: 403–410

    Google Scholar 

  27. Kennedy JC, Roth JH, Mendenhall HV, Sanford JB (1980) Presidential address. Intraarticular replacement in the anterior cruciate ligament-deficient knee. Am J Sports Med 8: 1–8

    Google Scholar 

  28. McCarthy JA, Blomstrom G, Shively RL, Steadman J, France P, Stonebrook S (1991) Maturation of biologic ACL-reconstructions: the effect of augmentation over time. Trans Orthop Res Soc 16: 202

    Google Scholar 

  29. McPherson GK, Mendenhall HV, Gibbons DF, et al (1985) Experimental, mechanical and histologie evaluation of the Kennedy ligament augmentation device. Clin Orthop 196: 186–195

    Google Scholar 

  30. Moyen B, Jeny JY, Mandrino A, Lerat JL (1992) Comparison of reconstruction of the anterior cruciate ligament with and without a Kennedy ligament augmentation device. J Bone Joint Surg [Am] 74: 1313–1319

    Google Scholar 

  31. Noyes FR, Barber SD (1992) The effect of a ligament-augmentation device on allograft reconstructions for chronic rupture of the anterior cruciate ligament. J Bone Joint Surg [Am] 74: 960–973

    Google Scholar 

  32. Noyes FR, Barber-Westin SD (1992) Posterior cruciate ligament allograft reconstruction with and without a ligament augmentation device. Arthroscopy 10: 371–382

    Google Scholar 

  33. Roth JH, Kennedy JC (1988) Polypropylene-braid-augmented anterior anterior cruciate ligament reconstruction. In: Friedman MJ, Ferkel RD (eds) Prosthetic ligament reconstruction of the knee. Saunders, Philadelphia, pp 79–88

    Google Scholar 

  34. Roth JH, Kennedy JC, Lockstadt H, et al (1985) Polypropylene braid augmented and nonaugmented intraarticular anterior cruciate ligament reconstruction. Am J Sports Med 13: 321–336

    Google Scholar 

  35. Roth JH, Shkrum MJ, Bray RC (1988) Synovial reaction associated with disruption of polypropylene braided augmented intraarticular anterior cruciate ligament reconstruction: a case report. Am J Sports Med 16: 301–305

    Google Scholar 

  36. Santi MD, Richardson AB (1994) The ligament augmentation device in hamstring grafts for reconstruction of the anterior cruciate ligament. Am J Sports Med 22: 524–530

    Google Scholar 

  37. Saraglia D, Leroy JM, Tourne Y, et al (1994) Rèsultats à moyen terme de 173 plasties du ligament croisé antérieur selon la technique de Mac Intosh renforcée par Kennedy Lad. Rev Chir Orthop 80: 230–238

    Google Scholar 

  38. Sgaglione NA, Delpizzo W, Fox JM, et al (1992) Arthroscopic assisted anterior cruciate ligament reconstruction with the semitendinosus tendon: comparison of results with and without braided polypropylene augmentation. Arthroscopy 8: 65–77

    Google Scholar 

  39. Shino K, Kawasaki T, Hirose H, et al (1984) Replacement of anterior cruciate ligament by an allogeneic graft. An experimental study in the dog. J Bone Joint Surg [Br] 66: 672–681

    Google Scholar 

  40. Sisk TD (1992) Synthetic augmentation for anterior cruciate ligament repair or reconstruction. In: Crenshaw AH (ed) Campbell's operative orthopaedies. Mosby-Year Book. St Louis, pp 1668–1686

    Google Scholar 

  41. Yamamoto H, Ishibashi T, Muneta T, et al (1992) Effusions after anterior cruciate ligament reconstruction using the ligament augmentation device. Arthroscopy 8: 305–310

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Kantonsspital, CH-9007, St. Gallen, Switzerland

    G. Stutz & A. Gächter

  2. Department of Orthopaedic and Traum Surgery, University Hospital Basle, Basle, Switzerland

    A. Boss

Authors
  1. G. Stutz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Boss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Gächter
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Investigation performed at the Department of Orthopaedic and Trauma Surgery, University Hospital Basle, Switzerland. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Funds were received in total or partial support of the research or clinical study presented in this article. The funding sources were SUVA Assurance, Lucerne, and the science fund of the University Hospital Basle

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stutz, G., Boss, A. & Gächter, A. Comparison of augmented and non-augmented anterior cruciate ligament reconstruction combined with high tibial osteotomy. Knee Surg, Sports traumatol, Arthroscopy 4, 143–148 (1996). https://doi.org/10.1007/BF01577406

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01577406

Key words

Search

Navigation