[Severe anterior sprains of the knee. Ligamentoplasty using the patellar tendon and reinforcement].

One hundred four severe knee sprains, treated by ligamentoplasty, according to Marshall-MacIntosh, with a Kennedy polypropylene ligament augmentation device, were reviewed with an average follow-up of 31 months. The functional result was evaluated as good or excellent in 3 out of the 4 cases; 87% of the sportsmen were satisfied. The result was unsatisfactory in 26% of the cases, with rupture or an elongation of the transplant in 9 cases (8.6%), due for some patients to premature resumption of sports; in 4 cases reoperation was necessary. A failure is always possible, even with an augmentation; however, with a ligament augmentation device, early rehabilitation and sports are possible (after an average of 6 months). There was no intolerance: 2 cases of synovitis, with a rupture, were observed. The authors underscore the ill effects of a delay between the accident and the stabilization, which causes numerous lesions of the menisci and the cartilage. This is generally admitted in the literature. The ligament augmentation device has been used for 3 years; the operation is performed after the acute phase of the first lesions and at the latest during the first year after the injury, before secondary lesions of the menisci occur.