Evaluation and management of the cruciate ligament-deficient knee present several problems. One of them is delay in diagnosis, and another is remaining instability in spite of previous operation of the knee.
We analysed the statistical data of the medical certificates for the road traffic accidents issued at National Medical Center from 1988 until 1989. The cruciate ligament injuries were 13.3%(74 cases) among the total issue of the medical certificates for road traffic accidents.
Recently, we used the Achilles tendon as autograft for reconstruction of the cruciate ligament. The main advantages of the Achilles tendon autograft are its sufficient length and strength. We compared the result of the reconstruction group using the Achilles tendon autograft with the medical certificate group of the cruciate ligament injury.
From the study, we obtained the following facts
1) The rate of early diagnosis of the cruciate liginent injury was very low, especially in multiple injuries.
2) Many cases of conservative treatment and operation only on the collateral ligament or meniscus result in remaining instability.
3) The rate of improvement of the knee instability after reconstuction of the cruciate ligament using Achilles tendon autograft was 89.4%.
In conclusion, we should keep in mind the possibility of the cruciate-;ligament injury in multiple injuries, especially in the fracture around the knee joint, and diagnose it as early as possible. Reconstructive procedures are essential in the cases showing instabililty more than moderate degree.
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