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Different views about the biomechanics of the knee joint and late
re construction of ligamentous injuries underline the obstacles
impeding the establishment of generally acceptable principles for
the treat ment of such lesions. As late as June 1976, HUGHSTON
emphasized in the Journal of Bone and Joint Surgery that in spite
of excellent anatomic studies, substantial uncertainty still
prevails in knee joint surgery. Even the signifi cance of the
anterior drawer sign for ruptures of the anterior cru ciate
ligament is interpreted quite diversely, as illustrated in a
comparison of HUGHSTON, GIRGIS, TORG, and SCHIECK, who give varying
opinions concerning the indication related to the age of the
patient or possible earlier joint damage as well as concerning the
prognosis for untreated knee joints. The question still remains as
to how often an intra-articular ligamentous replacement should be
carried out in addition to extra-articular techniques (0 'DONOGHUE,
SLOCUM, NICHOLAS, HUGHSTON). Lastly the question of synthetic
ligament replacement must be clarified. After basic research has
well advanced, clinical ex perience must be discussed. Statements
concerning the therapeutic value of diverse procedures based solely
on knowledge of the literature remain problematic. For this reason
a workshop was held at the University of Heidelberg in the
Orthopedic Clinic (Head: Prof. Dr. H. COTTA) in June 1977, with the
aim of bringing together representatives of the different leading
schools in a round table discussion to comment on still unsolved
ques tions."
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