Long-term followup of anterior cruciate ligament reconstruction using the XXXX tendon substitution for chronic anterior cruciate ligament insufficiency.

@entity1 @entity121
At The Hospital for Special Surgery, the @entity121 tendon substitution (QTS), as described by Marshall, was performed for ACL insufficiency from 1973 to 1980. A review of the initial 60 @entity1 with a minimum of 4 years followup (average, 5.5 years) has been concluded. Thirty-eight @entity1 returned for examinations, and 11 returned questionnaires. Associated medial procedures were performed in 29 of the 38 examined @entity1 . Medial meniscus surgery was performed in 86% and lateral meniscus surgery in 28.9%. At followup, giving way, which was the main preoperative complaint, was eliminated in 30/38 examined and 9/11 questionnaire @entity1 (79%). In the examined group, three @entity1 were clear failures and five had mild transient instability. The pivot shift was present in 17 of 38 (45%) @entity1 examined: 21 @entity1 were negative, 9 were 1+ or a grind, 8 were 2+, and none were 3+. We have concluded that the QTS procedure will eliminate symptomatic instability in 79% of our @entity1 , but the high rate of a residual pivot shift (45%) and symptoms of instability (21%) require the addition of an extraarticular sling procedure. This appears to be related to the relatively poor strength characteristics of the tissue used in the QTS substitution.
