The Journal of Bone and Joint Surgery, Vol 74, Issue 9 1392-1402, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
The Ellison iliotibial-band transfer for a torn anterior cruciate ligament of the knee. Long-term follow-up
JS Reid, GA Hanks, A Kalenak, S Kottmeier and V Aronoff
Division of Orthopaedic Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
We studied the long-term results of the Ellison technique of
extra-articular transfer of the iliotibial band, without advancement of the
biceps tendon, as the sole operative treatment for a torn anterior cruciate
ligament. Thirty-two patients (thirty-two knees) were evaluated an average
of eleven years (range, seven to fifteen years) after the operation. The
average age at the time of the operation was twenty-two years (range,
sixteen to thirty-four years). Eighteen patients (56 per cent) had a
modified Lysholm score of less than 84 points, indicating symptoms during
the activities of daily living. Only six patients (19 per cent) had a
subjectively normal knee (a modified Lysholm score of more than 94 points).
The most common reason for a poor subjective score was the presence of
symptoms of instability, in twenty-four patients (75 per cent). Twenty-four
patients (75 per cent) had a positive pivot-shift test and twenty-nine
patients (91 per cent), a positive Lachman test. Twelve patients (38 per
cent) had severe (grade 3 or 4) radiographic changes. The radiographs of
the knee appeared normal (grade 0) in only eight patients (25 per cent).
There was a significant association between a meniscal injury and
radiographic changes (p < 0.05). Fourteen patients (44 per cent) had
subsequent procedures due to persistent instability or pathological changes
in the articular cartilage or in a meniscus. There was a significant
decline in the subjective and objective knee scores in the twenty-one
patients who were evaluated at both two and eleven years. The number of
patients who had a positive pivot-shift test increased from five (24 per
cent) to sixteen (76 per cent). Subjectively, the number of patients who
had a good result decreased from fourteen (67 per cent) to five (24 per
cent). Objectively, nine patients (43 per cent) had a rating of good at two
years; this fell to three (14 per cent) at eleven years. Symptomatic
instability, pain, and a positive pivot-shift test were the most common
reasons for a poor result. Because of the decline in the subjective and
objective scores, we no longer recommend the Ellison procedure as the sole
operative treatment for a torn anterior cruciate ligament of the knee.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
