A prospective study was performed of the first forty-seven consecutive
patients who had repair of a ruptured anterior cruciate ligament and
replacement with an allograft. Patients who had a rupture of another
ligament were excluded, to provide a homogeneous group. Twenty-two patients
received a fascia lata allograft and twenty-five patients received a
bone-patellar ligament-bone allograft. All patients were enrolled in an
exercise program to facilitate motion of the knee immediately after the
operation, and all patients returned for postoperative evaluation (mean,
forty months; range, twenty-five to sixty-seven months). The results were
based on a comprehensive subjective and objective rating system, which
assessed twenty factors. On testing with the KT-1000 arthrometer, 69 per
cent of the patients had less than three millimeters of increased
anterior-posterior displacement of the knee that had been operated on
compared with the contralateral knee, 26 per cent had three to five
millimeters, and 5 per cent had more than five millimeters. The knees that
had a bone-patellar ligament-bone allograft had significantly lower values
for anterior-posterior displacement than did those that had a fascia lata
allograft (p less than 0.05). Just one patient, the only one in whom the
fascia lata graft failed, had giving-way. There were no infections, and
there was no evidence of rejection of the allograft or documented
transmission of disease at the time of writing. A strict rating system was
used. Eighteen patients (38 per cent) had an excellent result, twenty-four
(51 per cent) had a good result, and five (11 per cent) had a fair or poor
result. Motion of the knee immediately postoperatively was not deleterious
to the allograft, and, because limitations of motion were identified and
treated in the early postoperative period, full motion (0 to 135 degrees)
was restored in all knees.