Anterior Cruciate Ligament Injuries ; Humans ; Knee Injuries ; diagnosis ; surgery ; Medial Collateral Ligament, Knee ; injuries ; Posterior Cruciate Ligament ; injuries

OBJECTIVETo investigate the clinical results of surgical treatment for acute posterolateral structures(PLS) injuries of knee joint.

METHODSTwelve patients (12 knees) with acute PLS injuries were treated from May 2006 to October 2008, including 9 males and 3 females, ranging in age from 23 to 47 years, with an average of 31 years. Nine patients had posterior cruciate ligament (PCL) injuries, 3 patients had both anterior cruciate ligament (ACL) and PCL injuries, and 7 patients had articular capsule injuries. The knee joint was explored under arthroscope and the meniscuses were repaired firstly, then the ACL was rebuilt, as well as the PCL and PLS at the same time. The popliteus muscle tendon unit(PMTU) and the lateral collateral ligament (LCL) were anatomy reconstructed using variant tendon according to the degree of injury. The cruciate ligament reconstructed and fixed after the PLS reconstruction. The capsule tears were treated by reinforced suture techniques in the end. IKDC and Lysholm score were used to evaluate the postoperative knee joint function.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 24 months,with an average of (16.5 +/- 3.2) months. According to IKDC standard, 8 cases restored to normal (grade A), 3 cases near to normal(grade B) and 1 poor (grade C). The preoperative Lysholm joint function score was (39.6 +/- 3.1) and improved to (85.1 +/- 2.2) after surgery. All the patients were satisfied with their operation because of no-swelling and no-pain of the knee joint.

CONCLUSIONThe acute PLS injuries should be repaired with anatomy reconstruction of the PMTU and LCL which were the most important structure of the PLS. The operative procedure required accurate establishment of the bone tunnel, protection of fibular nerve, and avoiding the incision of the variant tendon, thus can make the PLS more stable after the reconstruction.

Acute Disease ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures

Anterior Cruciate Ligament Injuries ; Biomechanical Phenomena ; Humans ; Knee Joint/surgery* ; Posterior Cruciate Ligament/surgery* ; Posterior Cruciate Ligament Reconstruction ; Reconstructive Surgical Procedures ; Robotics

Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Humans ; Menisci, Tibial ; surgery ; Posterior Cruciate Ligament ; surgery ; Rotator Cuff ; surgery ; Rotator Cuff Injuries

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.

METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.

RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.

CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods

OBJECTIVE: To observe the curative effect of one-stage reconstruction of anterior cruciate ligament(ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL) in patients with KD-Ⅲ-M knee injury, and to compare the operation time, hospitalization cost and curative effect after arthroscopic reconstruction of PCL with LARS artificial ligament and autogenous hamstring tendon, ACL reconstruction with autogenous hamstring tendon and MCL repair combined with limited incision. METHODS: From March 2016 to January 2019, a total of 36 patients met the criteria of this study. Twenty patients in group A were treated with autogenous hamstring tendon reconstruction of ACL and PCL and repair of MCL, including 17 males and 3 females, with an average age of (34.7±9.2) years old. Sixteen patients in group B with LARS artificial ligament reconstruction of PCL, with an autogenous hamstring tendon reconstruction of PCL and MCL repair as before as group B, including 15 males and 1 female, with an average age of (36.8±8.6) years old. The operation time, hospitalization time and total hospitalization cost were compared between the two groups. The preoperative and postoperative functions of the two groups were evaluated by Hospital for Sepcial Surgery (HSS) score and Lysholm score respectively, and the curative effects were compared within and between groups. RESULTS: All the patients in the two groups were followed up for at least 1 year. There were no complications such as infection and poor wound healing in both groups. There was significant difference in operation time between (120.25±9.55) min in group A and (106.63±8.85) min in group B ( CONCLUSION There was no significant difference in the average hospitalization days between the two groups, but the operation time in group A was longerthan that in group B, and the hospitalization cost in group B was higher than that in group A. There was no difference in HSS score and Lysholm score before and follow-up for a certain period of time after operation.
Adult ; Anterior Cruciate Ligament/surgery* ; Anterior Cruciate Ligament Injuries/surgery* ; Arthroscopy ; Female ; Hamstring Tendons/surgery* ; Humans ; Knee Dislocation ; Knee Joint/surgery* ; Male ; Middle Aged ; Posterior Cruciate Ligament/surgery* ; Posterior Cruciate Ligament Reconstruction ; Treatment Outcome

Adult ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult

OBJECTIVE: To explore the effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament (PCL) tibial insertion fractures in adults. METHODS: Between October 2019 and October 2021, 16 patients with PCL tibial insertion fractures were treated with arthroscopic binding fixation using suture through single bone tunnel. There were 11 males and 5 females with an average age of 41.1 years (range, 26-58 years). The fractures were caused by traffic accident in 12 cases and sports in 4 cases. The time from injury to operation ranged from 2 to 10 days with an average of 6.0 days. The fractures were classified as Meyers-McKeever type Ⅱ in 4 cases and type Ⅲ in 9 cases, and Zaricznyi type Ⅳ in 3 cases. There were 2 cases of grade Ⅰ, 7 cases of grade Ⅱ, and 7 cases of grade Ⅲ in the posterior drawer test. There were 3 cases combined with lateral collateral ligament injury and 2 cases with meniscus injury. The visual analogue scale (VAS) score, Lysholm score, International Knee Documentation Committee (IKDC) score, and knee range of motion were used to evaluate knee joint function. The posterior drawer test and knee stability tester (Kneelax 3) were used to evaluate knee joint stability. The X-ray films were used to evaluate fracture reduction and healing. RESULTS: All incisions healed by first intention after operation. There was no incision infection, popliteal neurovascular injury, or deep venous thrombosis of lower limbs. All patients were followed up 6-12 months, with an average of 10 months. X-ray films at 6 months after operation showed the fractures obtained bone union. There were 11 cases of grade 0, 4 cases of gradeⅠ, and 1 case of grade Ⅱin posterior drawer test, showing significant difference when compared with preoperative results ( Z=23.167, P<0.001). The VAS score, Lysholm score, IKDC score, knee range of motion, and the results of Kneelax3 examination all significantly improved when compared with preoperative results ( P<0.05). CONCLUSION For adult patients with PCL tibial insertion fractures, the arthroscopic binding fixation using suture through single bone tunnel has the advantages of minimal trauma, good fracture reduction, reliable fixation, and fewer complications. The patient's knee joint function recovers well.
Adult ; Female ; Humans ; Male ; Anterior Cruciate Ligament Injuries/surgery* ; Arthroscopy/methods* ; Knee Joint/surgery* ; Posterior Cruciate Ligament/injuries* ; Suture Techniques ; Sutures ; Tibial Fractures/surgery* ; Treatment Outcome ; Middle Aged

OBJECTIVETo explore the clinical characteristic of the multiple-ligament injured knee and evaluate the protocol, technique and outcome of treatment for the multiple-ligament injured knee.

METHODSFrom October 2001 to March 2005, 9 knees with combined anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in 9 patients were identified with clinical and arthroscopic examinations. Of them, 5 knees were combined with ruptures of posteromedial corner (PMC) and medial collateral ligament (MCL), 4 with disruptions of posterolateral corner (PLC), 2 with popliteal vascular injuries and 1 with peroneal nerve injuries. Six patients were hospitalized in acute phase of trauma, 2 received repairs of popliteal artery and 4 had repairs of PMC and MCL. Reconstructions of ACL and PCL with autografts under arthroscope were performed in all patients at 4 to 10 weeks after trauma, including reconstruction of PLC with the posterior half of biceps femoris tendon tenodesis in 4 patients and reconstructions of PMC and MCL with femoral fascia in 1 patient.

RESULTSNo severe complications occurred at early stage after operation in the 9 patients. All of them were followed-up for 10-39 months with an average of 23.00 months+/-9.46 months. Lysholm score was 70-95 with an average of 85.00+/-8.29. International Knee Documentation Committee (IKDC) score was from severely abnormal (Grade D) in 9 knees at initial examination to normal (Grade A) in 2 knees, nearly normal (Grade B) in 6 knees and abnormal in 1 knee at the last follow-up. Of the 9 patients, 7 returned to the same activity level before injury and 2 were under the level.

CONCLUSIONSThe multiple-ligament injured knee with severe instability is usually combined with other important structure damages. Therefore, careful assessment and treatment of the combined injuries are essential. Reconstructions of ACL and PCL under arthroscope, combined with repairs or reconstructions of the extraarticular ligaments simultaneously or in stages, have advantage of minimal trauma in surgery and satisfactory outcome.

Adult ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; rehabilitation ; surgery ; Male ; Posterior Cruciate Ligament ; injuries ; Range of Motion, Articular

OBJECTIVETo investigate clinical outcomes of tendon allograft reconstruction with arthroscopy minimally invasive technique at stage I for the treatment of knee dislocation with multiple ligaments injury.

METHODSForty-eight patients with knee dislocation were reconstructed anterior and posterior ligament under arthroscopy at stage I from January 2008 to January 2012, and repaired ligaments injury of knee joint by minimally invasive technique. There were 38 males and 10 females aged from 20 to 59 years old with an average of 35.6 years old; 22 cases on the left side and 26 cases on the right side; the time from injury to operation ranged from 2 d to 2 weeks. Two cases combined with anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and posterolateral complex injuries, 36 cases combined with ACL, PCL, and MCL injuries, 10 cases combined with ACL, PCL and PLC injuries; 4 cases combined with peroneal nerve injury. Lysholm scoring were used to compared the cases before operation and final following-up to evaluate knee function.

RESULTSAll patients were followed up from 12 to 30 months with an average of (18.2 ± 6.3) months. Activity and stability of joint were obviously improved. Lysholm score were improved from 40.3 ± 4.1 before operation to 87.0 ± 6.4 at final following-up.

CONCLUSIONReconstruction with arthroscopy minimally invasive technique at stage I for the treatment of knee dislocation with multiple ligaments injury could recover stability of joint better,reserve joint function. Preoperative training and postoperative individualized rehabilitation treatment is the key point of recover knee joint function.

Adult ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Female ; Humans ; Knee Dislocation ; rehabilitation ; surgery ; Male ; Middle Aged ; Multiple Trauma ; surgery ; Posterior Cruciate Ligament ; injuries ; Reconstructive Surgical Procedures ; methods