Instability of the Knee Joint and its Correction

The management of ruptures of the medial and cruciate ligaments of the knee is discussed. The importance of capsular damage and consequent rotational instability in combined ruptures of the medial and anterior cruciate ligament is emphasised. Direct suture repair of ruptured cruciate ligaments is often impossible, and intra-articular procedures to provide a replacement for the ligament are complicated and have proved disappointing.The importance of capsular laxity is emphasised and two new operations to correct this are described. One is a simple medial capsular advancement to correct minor rotational instability: the other is a reinforcement of the capsule with strips taken from each side of the ligamentum patellae. These operations are simple and initial results have been promising.