[One-stage repair and reconstruction of knee anterior cruciate ligament, posterior cruciate ligament, and medial collateral ligament].

OBJECTIVE

To investigate the effectiveness of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction combined with limited open repair of medial collateral ligament (MCL) in recovering the stability and the function of the knee.

METHODS

Between April 2003 and October 2010, 14 patients (14 knees) with multiple 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 falling 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 degrees and extension was 0 degrees 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 < 0.01).

CONCLUSION

For multiple 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.