Reconstruction of the anterior cruciate ligament using a torn meniscus

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Ferkel-RD; Fox-JM; Del-Pizzo-W; Friedman-MJ; Snyder-SJ; Dorey-F; Kasimian-D Center for Disorders of the Knee, Van Nuys, California. J-Bone-Joint-Surg-Am. 1988 Jun; 70(5): 715-23 In eighty of 100 patients, reconstruction of the anterior cruciate ligament using a torn meniscus was successful in restoring stability. The length of follow-up ranged from two to six years and the mean interval from injury to operation was two years. Preoperatively, all but one patient had a positive (2+ or 3+) Lachman test and a positive pivot-shift test. Only ten patients had evidence of major instability, as seen on either test. The result was the same regardless of whether the patient had had a concomitant extra-articular (Ellison) procedure. The results of arthroscopic biopsy in eleven patients did not support the hypothesis that the meniscus underwent metaplasia to ligamentous tissue. Although this procedure yielded results similar to those of other procedures in which autogenous tissues are used to reconstruct the ligament, the meniscus should rarely, if ever, be used for reconstruction of the anterior cruciate ligament. The procedure is indicated only for patients who, in addition to needing reconstruction of the anterior cruciate ligament, also have a torn meniscus that would otherwise have to be totally excised.