[Results of the Insall operation (plasty of the anterior cruciate ligament by transfer of the fascia lata with bone block) in the treatment of chronic anterior instability of the knee. Analysis of 30 cases with at least 1 year of follow-up].
The authors have performed the Insall procedure on 30 knees since 1981. The results are analysed with a minimum of one year follow-up. The procedure, which is an active transfer of the iliotibial tract to the tibial plateau is based on the action of the proprioceptive structure of the muscles of the thigh. It produced a decrease of 50 p. 100 in the anterior drawer sign, the Lackman test disappeared in two thirds of the cases and the pivot-shift test disappeared in four knees out of five. Twenty-two patients engaged in some kind of sport before their accident; 17 were able to practice their sport at the same level after the operation. The results as evaluated by the CLAS system were good in 23, fair in five and poor in two. The indications are discussed and the results compared with those obtained after other procedures. This procedure should be performed on patients suffering disabling instability in daily life with a marked anterior drawer sign, but who are not high level athletes. The technical details are given. The transfer should be sufficiently massive, solid and well vascularised. The lateral stability of the knee should not be impaired by the procedure.