Long Term Results of Surgery for Non-Acute Anteromedial Rotatory Instability of the Knee

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Abstract
Patients [78] treated by extraarticular reconstruction including pes anserinus transfer for anteromedial rotatory instability of the knee were reinvestigated 16-47 mo. (mean 28) after operation. Function before and after operation was assessed by a knee rating score. Of these patients, 94% showed a higher score after operation. Some [20%] showed full recovery with no knee function limitation. The follow-up score was higher with preserved medial meniscus function than when this structure had been removed. When not initially torn, the medial meniscus tended to become involved with time. Mild laxity in extension, possibly indicative of a posterior cruciate injury previously underestimated or not observed, was found in 15% of the patients. No correlation was found between late knee function and the interval between injury and operation or the interval between operation and follow-up examination. The long term resutls were good. Extraarticular reconstruction is thus indicated in cases of chronic rotatory anteromedial instability. Routine meniscectomy is not recommended. Signs possibly indicating posterior cruciate ligament involvement should be carefully sought, as even minor posterior cruciate injury, easily overlooked, may influence the late results.