Abstract
This paper discusses the long-term results of the anterior cruciate ligament (ACL) reconstruction with the Leeds-Keio (LK) prosthetic ligament. For this type of reconstruction we used arthrotomy and an arthroscopy-assisted technique. The fixation was obtained with two bone plugs, and the distal portion was also attached with a staple. A postoperative protocol was used with a progressive range of motion and weight bearing after 50 days. We performed 50 LK operations in professional and amateur athletes aged 17–39 years with an isolated anterior instability. We reviewed at follow-up (5–7 years) 37 patients; 8 were lost, and 5 had a subsequent failure. At the Lysholm score the patients were classified: 19 excellent, 13 good, 3 fair, and 2 poor. At the IKDC grading the patients were classified as follows: 2 class A, 22 B, 8 C, and 5 D. The Lachman test was 1+ in 15 patients, 2+ in 7, 3+ in 2, and negative in 13: pivot shift was 1+ in 9, 2+ in 7, 3+ in 2, and negative in 25. Results of the KT 1000 test at 30 Ib side to side was <3 mm in 23 patients, 3–5 mm in 6, 6–10 mm in 6, and >10 mm in 2. In view of the results observed and the progressive deterioration over the years, this procedure should no longer be performed as an ACL substitute.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Armitage P (1971) Statistical methods in medical research. Oxford and Edinburgh Blackwell Scientific 408–414
Bach BR (1989) Arthroscopically assisted patella tendon substitution for ACL insufficiency. Am J Knee Surg 2:3–20
Bolton CW, Bruchman WC (1985) The GORETEX expanded polytetrafluoroethylene prosthetic ligament. An in vitro and in vivo evaluation. Clin Orthop Relat Res 196:202–207
Daniel DM, Malcom LL, Losse G, Stone ML, Sachs R, Burks R (1985) Instrumented measurement of anterior laxity of the knee. J Bone Joint Surg [Am] 67:720–726
Denti M, Arosio A, Monteleone M, Peretti G (1990) Preliminary assessment of anterior cruciate reconstruction with the Leeds-Keio artificial ligament. Am J Knee Surg 3:181–186
Denti M, Monteleone M, Schiavone Panni A, Perego P, Colzani G (1992) Preliminary results of a comparative experimental histological study in reconstruction of the anterior cruciate ligament. J Sports Traumatol Rel Res 114:11–18
Engstrom B, Wredmark T, Westblad P (1993) Patellar tendon or Leeds-Keio graft in the surgical treatment of the anterior cruciate ligament ruptures. Intermediate results. Clin Orthop Relat Res 295:190–197
Feagin JA, Curl WW (1976) Isolated tear of the anterior cruciate ligament. 5 years follow-up. Am J Sports Med 4:95–100
Fujikawa K (1986) Clinical study of anterior cruciate ligament reconstruction with the Leeds-Keio artificial ligament. In: friedman MJ, Ferkel RD (eds) Prosthetic ligament reconstruction of the knee. Saunders. Philadelphia, pp 132–139
Fujikawa K, Iseki F, Tomatsu T, Takeda T, Seedhom B (1984) Microscopic and histological findings after reconstruction of the anterior cruciate ligament by the Leeds-Keio artificial ligament. Knee 10:35–40
Galway RD, Beaupré A, MacIntosh DL (1972) Pivot shift: a clinical sign of symptomatic anterior cruciate insufficiency. J Bone Joint Surg [Br] 54:763–764
Gillquist J (1987) Important factors in the use of the Dacron ligament. Acta Orthop Belg 53:353–356
Hefti F, Muller W, Jakob RP, Staubli HU (1993) Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthroscopy 1:226–234
Lysholm J, Gillquist J (1982) Evaluation of the knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–155
Marcacci M, Gubellini P, Buda R, De Pasquale V, Strocchi R, Paladini Molgora A, Zaffagnini S, Guizzardi S, Ruggeri A (1991) Histologic and ultrastructural findings of tissue ingrowth. The Leeds-Keio prostetic anterior cruciate ligament. Clin Orthop Relat Res 267:115–121
McLoughling SJ, Smith RB (1992) The Leeds-Keio prosthesis in chronic anterior cruciate deficiency. Clin Orthop Relat Res 283:215–222
Mollica Q, Dal Poggetto A, Niceforo A, Ferlazzo M, Puzzolo D, Pisani A, Anastasi G (1988) Evoluzione biologica del legamento Leeds-Keio nel ginocchio umano: aspetti microscopici, istologici ed ultrastutturali. Ital J Orthop Traumatol 4:515–527
Schiavone Panni A, Denti M, Franzese S, Monteleone M (1993) The bone ligament junction: comparison between biological and artificial ACL reconstruction. Knee Surg Sports Traumatol Arthroscopy 1:9–12
Schindhelm K, Rogers GJ, Milthorpe BK, Hall PJ, Rolfe Howlett C, Sekel R, Goldberg J, Viglione W (1991) Autograft and Leeds-Keio reconstruction of the ovine anterior cruciate ligament. Clin Orthop Relat Res 267:278–292
Seedhom BB, Fujikawa K, Atkinson PJ (1984) The Leeds-Keio artificial ligament for replacing the cruciates. I Mech E 2: 99–110
Torg JS, Conrad W, Kalen V (1976) Clinical diagnosis of anterior crucial ligament instability in the athlete. Am J Sports Med 4:84–93
Wredmark T, Engstrom B (1993) Five-year results of anterior cruciate ligament reconstruction with the Stryker Dacron highstrength ligament. Knee Surg Sports Traumatol Arthroscopy 1: 71–75
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Denti, M., Bigoni, M., Dodaro, G. et al. Long-term results of the Leeds-Keio anterior cruciate ligament reconstruction. Knee Surg, Sports traumatol, Arthroscopy 3, 75–77 (1995). https://doi.org/10.1007/BF01552378
Issue Date:
DOI: https://doi.org/10.1007/BF01552378