Twenty patients who had substitution of the anterior cruciate ligament
with a Gore-Tex synthetic ligament were evaluated preoperatively and
postoperatively with the University of California at Los Angeles
instrumented clinical-testing apparatus, which records anterior-posterior
force versus displacement-response curves of the tibia with respect to the
femur at 20 degrees of flexion of the knee. The mean age of the patients
was thirty-three years (range, nineteen to fifty-four years). The duration
of follow-up ranged from twenty-four to forty-four months (mean, thirty-one
months). The mean preoperative difference in anterior laxity between the
injured knee and the normal knee (4.5 millimeters with neutral rotation of
the foot) was unchanged two years after the operation; at that time, all
patients had an anterior laxity of the injured knee of more than eight
millimeters, and 90 per cent had a difference in anterior laxity of more
than two millimeters between sides. The mean values for anterior stiffness
at fifty and 100 newtons of anterior force were unchanged after the
operation, remaining at 40 to 50 per cent of normal levels. At 200 newtons,
or 20.4 kilograms (forty-five pounds) of anterior force, the mean stiffness
of the involved knee was 11 to 17 per cent greater than that of the normal
knee. Clinically, there were improvements in both subjective and objective
knee-rating scores. All but four patients had a reduction of at least one
grade in the pivot-shift score; in thirteen, the pivot-shift sign was
eliminated.(ABSTRACT TRUNCATED AT 250 WORDS)