Abstract
The association of an anterior cruciate ligament (ACL) tear and a posterior cruciate ligament (PCL) injury is rare in athletes, and to our knowledge it has never been described in a professional rugby player. We report the case of a 27-year-old international professional rugby player who presented with an ACL tear associated with chronic posterior laxity on a former PCL tear. The procedure associated arthroscopic ACL and PCL reconstruction in a one-stage operation with two autografts, bone-patellar tendon-bone and hamstring tendon, respectively. At 7 months postoperatively, the patient had returned to playing rugby at the same level of play. The therapeutic strategy successfully met the established goals of returning to sports at the same level of play with excellent functional results after 2 years of follow-up. A literature review was performed via PubMed. The inclusion criteria were the studies in English language, assessing the return-to-sport after bicruciate ligament reconstruction in athletes. Eight studies were included in analysis. Only one study has focused on the return-to-sport in 24 competitive athletes and two other studies have included 1 professional athlete each. The overall rate of the return-to-sport after bicruciate reconstruction varied between 100% and 50%.
Highlights
Anterior (ACL) and posterior (PCL) cruciate ligament tears are frequent and severe in professional rugby players [1, 2]
A 27-year-old patient who was an international professional rugby player consulted for a knee sprain that occurred during training after landing from a jump without player contact
The tibial tunnel for semitendinosus and gracilis (STG) reconstruction of the posterior cruciate ligament (PCL) was performed under fluoroscopic control through an accessory posteromedial portal, and the tibial tunnel for bonepatellar tendon-bone (BTB) reconstruction of the anterior cruciate ligament (ACL) was drilled
Summary
Anterior (ACL) and posterior (PCL) cruciate ligament tears are frequent and severe in professional rugby players [1, 2]. To our knowledge there is no published report of a recent ACL tear on a knee with a prior PCL tear in this population. The goal of treatment is to return rapidly to sports at the same level of play. An ACL tear in an athlete is an indication for ligament reconstruction, while, on the other hand, an isolated PCL tear with low grade laxity, with no associated injury of peripheral structures, is treated conservatively with functional rehabilitation for a rapid return-to-sports [3]. A bicruciate ligament reconstruction was performed in a one-stage procedure
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