Abstract
Anterior cruciate ligament (ACL) insufficiency in combination with patellar instability are rare occurrences and are difficult to treat. Failure to address patellar instability in such cases may place excessive strain on ACL graft leading to graft rupture. We present three such cases treated by concurrent ACL and medial patellofemoral ligament (MPFL) reconstruction with hamstring tendon autografts. Two patients had MRI evidence of MPFL injury and one patient had intact MPFL on MRI. All patients had good outcome without any residual instability at final follow-up.
Highlights
Anterior cruciate ligament (ACL) is the primary restraint to anterior translation of tibia and is one of the most commonly injured ligaments
We present three such cases treated by concurrent ACL and medial patellofemoral ligament (MPFL) reconstruction with hamstring tendon autografts
We describe the surgical technique and follow-up of three such cases of this combined injury pattern managed with concurrent ACL and MPFL reconstruction using hamstring tendon autografts
Summary
Anterior cruciate ligament (ACL) is the primary restraint to anterior translation of tibia and is one of the most commonly injured ligaments. Clinical examination revealed positive Lachman, grade I pivot shift, and grade II anterior drawer Her knee range of motion (ROM) was near full with a positive patellar apprehension on the affected side. Clinical examination revealed positive Lachman, grade II pivot shift, and grade II anterior drawer Her knee ROM was full with a positive patellar apprehension on the affected side. A 28-year-old female came with complaints of left knee pain and instability following valgus injury while dancing three weeks back. Since she had experienced four episodes of patellar dislocation. Following MPFL fixation, prepared ST graft was passed through femoral and tibial tunnels and fixed using suspensory button proximally and interference screw distally to reconstruct ACL. She did not experience any difficulty and regained full range at 2 months followup
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