Reconstruction of multiple ligament injuries of the knee with autogenous hamstring tendons

Abstract

Objective To evaluate the results of a new surgical technique which augments the repair of superficial medial collateral ligament （sMCL） and posterior oblique ligament （POL）. Methods In our surgical procedure, the autogenous semitendinosus or gracilis tendon looped in shape was used to augment the repair of sMCL and POL. From February 2004 to August 2002, 21 patients with symptomatic medial instability underwent this surgical procedure. Most cases were complicated with cruciate ligament injuries, necessitating concomitant cruciate ligament reconstruction. In some cases, the hamstring tendon was harvested from the healthy side for the reconstruction. Results Of the 21 patients, 19 were evaluated after a mean follow-up period of 57 （range, 49-67） months. At follow-up, when valgus stress was applied to the knee at 0 and 30 degrees of flexion, their medial stability was graded as normal or nearly normal according to the International Knee Documentation Committee （IKDC） criteria. Their mean Lysholm score was 58.5 ± 4. 2 before surgery and 92.2 ± 3.6 at the last follow-up （ P 〈 0.05 ）. Six patients received manipulation for arthrofibrosis 3 months after operation. No patients complained of donor-side morbidity or disfunction of the healthy leg, except 2 cases who complained of numbness on the medial side. Conclusion It is reliable to augment the repair of sMCL and POL with autogenous hamstring tendons in shape, since it restores the medial stability of the knee. Key words: Collateral ligament; Posterior oblique ligament; Posteromedial corner