Arthroscopic ACL and PCL Reconstruction after Acute Knee Dislocation Using Autogenous Hamstring Graft with One Incision Technique

The treatment of multiple ligamentous ruptures of the knee arising from total knee dislocationis controversial. The potentially devastating consequences of this injury have prompted authors to give the treatment and outcome of vas-cular and neurologic injuries, and concomitant fracture, leading priority when reporting results. It is well accepted that the majority of knee dislocations result in rupture of both the ACL and PCL and, frequently, one or both of the collat-eral ligaments. Although a few early reports of the treatment of multiple liga-mentous ruptures recommended non-operative treatment of some or all of the ligamentous deficiencies, most authors have advocated allogenic or autogenous graft reconstruction of some or all involved ligamentous structures. The purpose of this investigation was to provide objective data and a critical rating of the results of operative treatment using autogenous hamstring grafts and immediate protected knee motion for combined ACL and PCL ruptures after complete knee dislocation. Since September 1996, we treated 10 patients with combined ruptures of the ACL and PCL after knee dislocation who received operative treatment for both cruciate ligaments. There were 8 males and 2 females. The average age was 26 years (range, 20 to 38). The involved site were 6 in right and 4 in left. The semi-tendinosus graft was harvested from contralateral knee for ACL reconstruction and semitendinosus with gracilis were harvested form ipsilateral knee for PCL reconstruction. Both hasmstring grafts were prepared by double loops. We fixed both grafts with endobutton in femoral end and screw with washer in tibial end. The mean follow-up was 26 months (range, 19 to 38). We adopted Lysholm and Tegner scoring system for evaluation. The result of Lysholm score was showed average 77.3 (range: 60 to 92) postoperatively. The Tegner score was 7.5 preop-eratively and 5.4 postoperatively. The side-to-side total A-P translation with knee 20˚ flexion showed average 2.3 mm (range: -3 to +7). This grading showed good to excellent were 70% (7/10). There were three patients sustained arthrofi-brosis 16 weeks postoperatively but got improved after series manipulation under anesthesia. We provided this surgical technique unlike another authors. The prelimi-nary results were promising but long-term results should be followed up closely.

並列關鍵字

Arthroscopy ； Anterior cruciate ligament ； posterior cruciate lig-ament ； knee dislocation ； Hamstring tendon

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