The course of differently treated isolated ruptures of the anterior cruciate ligament as observed by prospective stress radiography.

In a prospective stress radiographic study of the course of 21 isolated anterior cruciate ligament (ACL) injuries, primary suture was performed in eight patients and reconstruction due to chronic instability was performed in six patients. Seven patients were treated by exploratory arthrotomy only. After a follow-up period of seven years the anterior drawer sign had disappeared in five of the 14 patients who had shown this sign prior to operation, but in some of these patients progressive rotatory instabilities developed, so that the total abnormal instability did not improve in any of the three therapeutic groups. Only ten patients obtained a completely symptom-free knee. A well performed Jones procedure could reduce a chronic anterior drawer instability, but in several of the patients troublesome patellofemoral pain developed later. Acute suture of isolated anterior cruciate ligament injuries afforded the best results in this series and is recommended.