[EFFECTIVENESS OF ONE-STAGE REPAIR AND RECONSTRUCTION OF TRAUMATIC DISLOCATION OF KNEE JOINT COMBINED WITH MULTIPLE LIGAMENT INJURIES].

OBJECTIVE: To investigate the effectiveness of one-stage repair and reconstruction of multiple ligament injuries of the knee under arthroscopy.

METHODS: Between March 2007 and March 2009, 25 patients (25 knees) with multiple ligament injuries of the knee underwent one-stage repair and reconstruction under arthroscopy. Of 25 cases, 16 were male and 9 were female with an average age of 29.6 years (range, 18-43 years). The causes of injury were traffic accident injury in 20 cases, falling injury from height in 3 cases, and sport injury in 2 cases. The time between injury and surgery was 8-14 days (mean, 10.5 days). The preoperative Lysholm score was 37.92 ± 3.57. The X-ray film and MRI examinations showed that 17 patients had tears of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and medial collateral ligament, and 8 patients had tears of ACL, PCL, and posterolateral corner (PLC); 5 cases had medial meniscus injury and 7 cases had lateral meniscus injury. The ACL, PCL, and PLC were reconstructed under arthroscopy with autologous tendon or allogeneic tendon, and the MCL was repaired. Early active and passive functional exercises were done postoperatively.

RESULTS: All the incisions healed by first intention, and there was no complications of infection and deep venous thrombosis. Twenty-five patients were followed up 24-78 months (mean, 50.9 months). Six patients had knee stiff postoperatively; after manipulation under anesthsia, 5 patients lost less than 15° of flexion and only 1 patient lost 26° of flexion. At last follow-up, the stability of the knee joint was significantly improved. There were significant differences in the anterior drawer test, posterior drawer test, Lachman test, and varus stress and valgus stress testing at 30° between at last follow-up and at preoperation (P < 0.05). The postoperative Lysholm score was 87.84 ± 4.85, which was significantly better than the preoperative score (t = 52.053, P = 0.000). The International Knee Documentation Committee (IKDC) rating was nearly normal in 16 cases (64%), abnormal in 8 cases (32%), and obviously abnormal in 1 case (4%).

CONCLUSION: One-stage repair and reconstruction of multiple ligament injuries of the knee under arthroscopy can effectively restore the function of the knee joint, and the effectiveness is reliable.