Abstract des Autors

Purpose was to examine the reasons for the observed spontaneous stabilization of the knee joint after complete ACL rupture in conservative treated patients. From 1996 until 1997 19 of 244 patients (7.8%) with acute rupture of the ACL showed more stable conditions after non-operative, conservative treatment. Our results base upon clinical findings including the Lysholm-score (n=19), MRI (n=5) and arthroscopy (n=10). Initially the examined knees were unstable with a ++ to +++ positive Lachman-sign without endpoint. After ten weeks (6 to 19 weeks) of conservative treatment we found the stability of the knee joints improved, the Lachman-sign was + to ++ positive with an endpoint. The MRI findings were reinsertions of the ACL either anterior of the original point or on the top of the PCL. Arthroscopy showed the ACL reinserted at the inner side of the lateral femur condyle anterior the anatomic insertion in all cases. The scores increased during the period of conservative treatment. In conclusion the reinserted ACL anterior the original insertion after rupture correlates with an objective and subjective decrease of knee instability. Verf.-Referat