ONE-STAGE REPAIR AND RECONSTRUCTION OF KNEE ANTERIOR CRUCIATE LIGAMENT, POSTERIOR CRUCIATE LIGAMENT, AND MEDIAL COLLATERAL LIGAMENT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHEN Pingquan , ZHU Zhenkang , WANG Sheng.

Department of Orthopedics and Traumatology, Affiliated Jiaxing Traditional Chinese Medical Hospital, Zhejiang Chinese Medical University, Jiaxing Zhejiang, 314001, P.R.China.;

Corresponding author：

Keywords：

Knee joint; Multi ple injuries of ligaments; Ligament repair and reconstruction

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Objective To investigate the effectiveness of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction combined with l imited open repair of medial collateral ligament (MCL) in recovering the stabil ity and the function of the knee. Methods Between April 2003 and October 2010, 14 patients (14 knees) with multi ple injuries of ACL, PCL, and MCL were treated. There were 10 males and 4 females with an average age of 41 years (range, 21- 71 years). Injury was caused by traffic accident in 11 cases and fall ing in 3 cases. The average time from injury to admission
was 2 days (range, 1-4 days). Lysholm score was 17.00 ± 8.29, and the International Knee Documentation Committee (IKDC) score was 20.93 ± 8.28. The complicated injuries included dislocation of the knee joint in 9 cases and meniscus injury in 5 cases. Allogeneic tendons (2 cases) and autologous harmstring tendon (12 cases) were used to reconstruct ACL and PCL under arthroscopy, and all cases underwent limited open repair of MCL. Results All incisions healed by first intention. Numbness of the lower limb occurred in 3 cases and alleviated spontaneously. All patients were followed up 14 months on average (range, 12-18 months). The knee flexion was 120° and extension was 0° at 3 months of follow-up. After 1 year of follow-up, IKDC score and Lysholm score were 89.93 ± 6.26 and 88.93 ± 4.82, respectively, showing significant differences when compared with preoperative scores (P lt; 0.01). Conclusion For multi ple injuries of the knee ligaments, an arthroscope with limited open repair and reconstruction of the knee ligament can avoid open joint chamber, reduce postoperative articular adhesion, and encourage the joint function recovery.

Citation： CHEN Pingquan,ZHU Zhenkang,WANG Sheng.. ONE-STAGE REPAIR AND RECONSTRUCTION OF KNEE ANTERIOR CRUCIATE LIGAMENT, POSTERIOR CRUCIATE LIGAMENT, AND MEDIAL COLLATERAL LIGAMENT. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(6): 675-678. doi: Copy

1.	Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med, 1982, 10(3): 150-154.
2.	Anders JO, Struwe MS, Sander K, et al. Radiological and clinical functional examinations 36 months after anterior cruciate ligament repair by a patellar tendon graft. Z Orthop Unfall, 2007, 145(6): 719-725.
3.	胥少汀, 葛宝丰, 徐印钦. 实用骨科学. 3版. 北京: 人民军医出版社, 2005: 194-218.
4.	邱贵兴, 戴尅戎. 骨科手术学. 3版, 北京: 人民卫生出版社, 2005: 610.
5.	Canale ST. 坎贝尔骨科手术学. 卢世璧, 主译. 10版. 济南: 山东科学技术出版社, 2005: 2168-2172, 2414-2417.
6.	中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华骨科杂志, 2009, 29(6): 602-604.
7.	Mook WR, Miller MD, Diduch DR, et al. Multiple-ligament knee injuries: a systematic review of the timing of operative intervention and postoperative rehabilitation. J Bone Joint Surg (Am), 2009, 91(12): 2946-2957.
8.	Hayashi R, Kitamura N, Kondo E, et al. Simultaneous anterior and posterior cruciate ligament reconstruction in chronic knee instabilities: surgical concepts and clinical outcome. Knee Surg Sports Traumatol Arthrosc, 2008, 16(8): 763-769.
9.	Malizos KN, Xenakis T, Mavrodontidis AN, et al. Knee dislocation and their management. A report of 16 cases. Acta Orthop Scand Suppl, 1997, 275: 80-83.
10.	Petersen W, Laprell H. Combined injuries of the medial collateral ligament and anterior cruciate ligament. Early ACL reconstruction versus late ACL reconstruction. Arch Orthop Trauma Surg, 1999, 119(5-6): 258-262.
11.	岳勇, 阿德力, 哈巴西, 等. 膝关节前交叉韧带损伤的早期手术和晚期手术的系统评价. 中国矫形外科杂志, 2008, 16(12): 900-903.
12.	Lee S, Seong SC, Jo CH, et al. Outcome of anterior cruciate ligament reconstruction using quadriceps tendon autograft. Arthroscopy, 2004, 20(8): 795-802.
13.	涂俊, 徐斌. 关节镜下自体腘绳肌腱移植重建前交叉韧带: 应用Rigidfix和Intrafix系统的比较. 中国组织工程研究与临床康复, 2010, 14(22): 4041-4046.
14.	张义龙, 李宁, 李志怀, 等. 自体与同种异体肌腱重建膝关节前交叉韧带的比较. 中国组织工程研究与临床康复, 2011, 15(31): 5743-5746.
15.	Samuelsson K, Andersson D, Karlsson J. Treatment of anterior cruciate ligament injuries with special refercnce to graft type and surgical technique: an assessment of randomized controlled trials. Arthroscopy, 2009, 25(10): 1139-1174.
16.	郭东辉, 韩广普, 任玉猛, 等. 锚钉技术重建膝关节内侧副韧带. 中国修复重建外科杂志, 2010, 24(12): 1528-1529.
17.	曾春, 卢华定, 蔡道章, 等. 关节镜下保留韧带残端的前交叉韧带重建. 中华创伤骨科杂志, 2010, 12(4): 324-328.

1. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med, 1982, 10(3): 150-154.
2. Anders JO, Struwe MS, Sander K, et al. Radiological and clinical functional examinations 36 months after anterior cruciate ligament repair by a patellar tendon graft. Z Orthop Unfall, 2007, 145(6): 719-725.
3. 胥少汀, 葛宝丰, 徐印钦. 实用骨科学. 3版. 北京: 人民军医出版社, 2005: 194-218.
4. 邱贵兴, 戴尅戎. 骨科手术学. 3版, 北京: 人民卫生出版社, 2005: 610.
5. Canale ST. 坎贝尔骨科手术学. 卢世璧, 主译. 10版. 济南: 山东科学技术出版社, 2005: 2168-2172, 2414-2417.
6. 中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华骨科杂志, 2009, 29(6): 602-604.
7. Mook WR, Miller MD, Diduch DR, et al. Multiple-ligament knee injuries: a systematic review of the timing of operative intervention and postoperative rehabilitation. J Bone Joint Surg (Am), 2009, 91(12): 2946-2957.
8. Hayashi R, Kitamura N, Kondo E, et al. Simultaneous anterior and posterior cruciate ligament reconstruction in chronic knee instabilities: surgical concepts and clinical outcome. Knee Surg Sports Traumatol Arthrosc, 2008, 16(8): 763-769.
9. Malizos KN, Xenakis T, Mavrodontidis AN, et al. Knee dislocation and their management. A report of 16 cases. Acta Orthop Scand Suppl, 1997, 275: 80-83.
10. Petersen W, Laprell H. Combined injuries of the medial collateral ligament and anterior cruciate ligament. Early ACL reconstruction versus late ACL reconstruction. Arch Orthop Trauma Surg, 1999, 119(5-6): 258-262.
11. 岳勇, 阿德力, 哈巴西, 等. 膝关节前交叉韧带损伤的早期手术和晚期手术的系统评价. 中国矫形外科杂志, 2008, 16(12): 900-903.
12. Lee S, Seong SC, Jo CH, et al. Outcome of anterior cruciate ligament reconstruction using quadriceps tendon autograft. Arthroscopy, 2004, 20(8): 795-802.
13. 涂俊, 徐斌. 关节镜下自体腘绳肌腱移植重建前交叉韧带: 应用Rigidfix和Intrafix系统的比较. 中国组织工程研究与临床康复, 2010, 14(22): 4041-4046.
14. 张义龙, 李宁, 李志怀, 等. 自体与同种异体肌腱重建膝关节前交叉韧带的比较. 中国组织工程研究与临床康复, 2011, 15(31): 5743-5746.
15. Samuelsson K, Andersson D, Karlsson J. Treatment of anterior cruciate ligament injuries with special refercnce to graft type and surgical technique: an assessment of randomized controlled trials. Arthroscopy, 2009, 25(10): 1139-1174.
16. 郭东辉, 韩广普, 任玉猛, 等. 锚钉技术重建膝关节内侧副韧带. 中国修复重建外科杂志, 2010, 24(12): 1528-1529.
17. 曾春, 卢华定, 蔡道章, 等. 关节镜下保留韧带残端的前交叉韧带重建. 中华创伤骨科杂志, 2010, 12(4): 324-328.

Chinese Journal of Reparative and Reconstructive Surgery

ONE-STAGE REPAIR AND RECONSTRUCTION OF KNEE ANTERIOR CRUCIATE LIGAMENT, POSTERIOR CRUCIATE LIGAMENT, AND MEDIAL COLLATERAL LIGAMENT

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