A prospective study was performed to determine the effect of a
combination of a ligament-augmentation device with a bone-patellar
ligament-bone allograft for the treatment of chronic rupture of the
anterior cruciate ligament. One hundred and fifteen knees in 110 patients
were divided into two groups. Group BLB consisted of sixty-six knees in
sixty-four patients who were managed with a bone-patellar ligament-bone
allograft only, and Group BLB-LAD consisted of forty-nine knees in
forty-six patients who were managed with both the allograft and a
ligament-augmentation device. Preoperatively, there were no statistically
significant differences between the two groups with regard to fifteen
variables. All patients were managed with the same postoperative program of
immediate motion and rehabilitation of the knee. All patients returned for
evaluation at a mean of thirty-four months (range, twenty-three to
fifty-three months) postoperatively. The results were evaluated with a
comprehensive rating system that assessed twenty factors. Both of these
procedures significantly decreased functional limitations and symptoms and
improved the level of sports activity and the over-all score. However, the
use of the ligament-augmentation device did not improve the efficacy of the
reconstruction with regard to any of the individual variables that were
assessed or in terms of the over-all score. All but one of the patients
regained an arc of 0 to 135 degrees of motion. Although the augmentation
device reduced anterior-posterior displacement effectively for the first
twenty weeks postoperatively (p less than 0.05), there was no difference
between the groups in terms of the percentage of knees that had abnormal
displacement at the latest follow-up. A new classification system was
developed to determine rates of failure. The over-all rate of failure was
28 per cent (thirty-two) of the 115 knees: 29 per cent (nineteen) of the
sixty-six knees in Group BLB and 27 per cent (thirteen) of the forty-nine
knees in Group BLB-LAD. The difference between the two groups was not
statistically significant. The addition of the ligament-augmentation device
did not improve the results of allograft reconstruction in the treatment of
chronic rupture of the anterior cruciate ligament. The use of either an
allograft alone or an allograft combined with a ligament-augmentation
device did not reduce the amount of anterior-posterior displacement
satisfactorily in all of the knees.