Abstract

From 1979 to 1984, 27 skiers who were either present or past members of the United States Ski Team or professional skiers had 30 ACL tears that were repaired primarily. Only two of the repairs were augmented with autogenous patellar tendon grafts. Five patients had complete knee dislocations, including tears of both cruciate ligaments. Nineteen patients had a concomitant extraarticular iliotibial band tenodesis. Twentyseven knees (24 patients) were followed an average of 57.6 months postoperatively. Recreational skiing was resumed at 5.4 months on average, and ski racing and pivot-requiring sports all but three patients resumed participation at an average of 9.1 months. In 78 of the knees there was pain-free function. Mild pain was reported in 19, the majority of which (4/5) was related to vigorous activity. Of the total, only two knees were reported to have a sensation of giving way. On clinical examination 85 (23/27) had normal pivot shift examination with no evidence of abnormal motion. Four percent (1/27) had a 1+test and 11 (3/27) had glides. Arthrometer measurements revealed an average of 7.76 mm anterior displacement with 20 pounds of force on the knee with an ACL repair as compared to 5.56 mm on the uninjured knee. The laxity measurements of knees with repaired ACLs fell within the range reported for uninjured knees in the normal population. Five patients had reinjuries to the ACL at an average time of 28 months postoperatively, with two of five undergoing rerepair. Only one patient had an iliotibial band tenodesis to supplement the original ACL repair. With proper surgical technique and rehabilitation, ACL repair can be statistically and functionally successful in elite skiers. The use of the iliotibial band tenodesis is essential for succesful ACL repair and the institution of immediate postoperative motion. Verf.-Referat