Surgical treatment of injury to posteromedial knee structure complicated with rupture of single cruciate ligament

Abstract

Objective To discuss clinical outcomes of surgical treatment of injury to the postero-medial knee structure complicated with rupture of anterior cruciate ligament(ACL)or posterior cruciate ligament(PCL).Methods Twelve cases of complex injury to posteromedial knee structure were treated from January 2002 to December 2005.Ten were complicated with ACL rupture and 2 with PCL rupture.The ruptured ACL or PCL was reconstructed by arthroscopy and the injured posteromedial structure was repaired by open approach.Autologous semitendinosus and gracilis were used for 8 ACL reconstruction and bone-patellar tendon-bone(B-T-B)technique for the other 2 ACL reconstructions.The ruptured PCL was reconstructed with allograft of achillis tendon.In repairing the injured posteromedial structure, 8 cases used star-shaped steel plates, 2 G 鈪?anchor screws, 1 autologous graft of semitendinosus and gracilis, and 1 end-to-end suture.Results All the cases were followed up for 12(6 to 18)months on average except the two who had a follow-up of only 4 months.The mean functional score of the knee improved from 56.7(50 to 60)preoperatively to 81.2(74 to 94)postoperatively by Lysholm system.Ten cases recovered normal range of knee flexion and extension after cruciate ligament reconstruction while 2 had a restricted extension of 5 degrees.Nine cases obtained an excellent result in lateral stress test at angle zero, 2 + and 1+ +.Conclusion Early reconstruction of cruciate ligament during repair of the posteromedial structure can result in excellent knee stability for the injury to the posteromedial knee structure complicated with rupture of single cruciate ligament. Key words: Knee joint; Anterior cruciate ligament; Posterior cruciate ligament; Wounds and injuries