OUTCOME OF SIMULTANEOUS ARTHROSCOPIC ANTERIOR AND POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING AUTOGENOUS GRAFTS WITH ALL-INSIDE TECHNIQUE

Vu Nhat Dinh1, Nguyen Ngoc Phung1, Hoang The Hung2, Vu Anh Dung1,
1 Trauma and Orthopaedics Center, Military Hospital 103
2 Institute of Trauma and Orthopaedics, 108 Central Military Hospital

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Introduction: Bicruciate knee ligament injury is a lesion affecting both the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL) simultaneously, which is one of the most severe knee joint injuries. Operative simultaneous reconstruction is the standard of treatment. Objectives: To evaluate clinical results of one-stage ACL and PCL reconstruction using autogenous tendon grafts with an all-inside technique. Material and methods: The medical records of patients operated on by a group of surgeons at the Orthopedic Center, Military Hospital 103 from March 2015 to March 2020 were retrospectively analyzed. Thirty-four patients (24 males, 10 females) with combined rupture of both ACL and PCL underwent one-stage ACL and PCL reconstruction using autogenous hamstring and peroneus longus tendon grafts with all-inside technique. Results: The mean time of follow-up was 32.09 ± 25.15 months (9 - 68 months). The mean age was 37.7 ± 9.0 years (range 23 - 56 years). At the final follow-ups, all patients were without limit extension, 5/34 patients (14.71%) with limit flexion. The Lachman test was negative in 32 patients (94.12%), the pivot shift testing in 32 patients (94.12%) was negative, 26 patients (76.47%) had a positive posterior drawer test. The Lysholm knee score preoperative and final follow-up were 46.76 ± 17.08 (range 12 - 82) and 89.29 ± 8.57 (range 50 - 99) (p < 0.01), respectively. Conclusion: This study demonstrates the effectiveness and safety of simultaneous arthroscopically assisted reconstruction of both ACL and PCL using autogenous hamstring and peroneus longus tendon for restoring knee stability with an all-inside technique.

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Tài liệu tham khảo

1. Dedmond B.T., Almekinders L.C. (2001). Operative versus non-operative treatment of knee dislocations. A meta-analysis. Am J Knee Surg; 14: 33-38.
2. Wascher D.C., Becker J.R., Dexter J.G., Blevins F.T. (1999). Reconstruction of the anterior and posterior cruciate ligaments after knee dislocation. Am J Sports Med; 27: 189-196.
3. Roman P.D., Hopson C.N., Zenni E.J. (1987). Traumatic dislocation of the knee: A report of thirty cases and literature review. Orthop Rev; 16(12): 917-924.
4. P. Saravanan, T. Sundararajan (2018). Single-stage arthroscopic anterior cruciate and posterior cruciate ligament reconstruction using hamstring tendon autograft. International Journal of Orthopedics; December 8(3): 54-59.
5. Chan Y.S., Yang S.C., Chang C.H., et al. (2006). Arthroscopic reconstruction of the posterior cruciate ligament using quadruple hamstring tendon graft with 3- to 5-year follow-up. Arthroscopy; 22: 762-770.
6. F.D. Shi, D.E. Hess, J.Z. Zuo, S.J. Liu, X.C. Wang, Y. Zhang, et al. (2018). Peroneus longus tendon autograft is a safe and effective alternative for anterior cruciate ligament reconstruction. J. Knee Surg; 1(212).
7. Nicos Papaloucas (2018). All-inside technique for ACL-reconstruction using a FlipCutter and the TightRope System. Surg Technol Int; 1(32): 337-345.
8. Yang-Pin Lo, Kuo-Yao Hsu, Lih-Huei Chen, Ching-Jen Wang, Wen-Ling Yeh, Yi-Sheng Chan, Wen-Jer Chen (2009). Simultaneous arthroscopic reconstruction of the anterior and posterior cruciate ligament using hamstring and quadriceps tendon autografts. J Trauma; 66: 780-788.
9. Riku Hayashi, Nobuto Kitamura, Eiji Kondo, Yuko Anaguchi, Harukazu Tohyama, Kazunori Yasuda (2008). Simultaneous anterior and posterior cruciate ligament reconstruction in chronic knee instabilities: Surgical concepts and clinical outcome. Knee Surg Sports Traumatol Arthrosc; 16: 763-769.