Acar Baver, Başarır Kerem, Armangil Mehmet, Binnet Mehmet Serdar
Department of Orthopedics and Traumatology, Antalya Education and Research Hospital Ankara.
Department of Orthopedics and Traumatology, Faculty of Medicine, Ankara University Ankara.
Int J Clin Exp Med. 2014 Oct 15;7(10):3710-3. eCollection 2014.
Main evidence of the heavy knee dislocations is the rupture of both Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL). There are limited sources for the treatment of both ligaments at a single stage. Materials-method: One-staged anatomic double-bundle ACL and PCL reconstruction technique has been applied to 2 cases aged 20 and 36 with traumatic knee dislocation. Lateral collateral ligament and posteriolateral corner reconstruction added to one case, and medial collateral ligament and posteriomedial corner reconstruction for the other case. Because of additional femur fractures of the both cases, ligament reconstructions have been applied after the main treatment. Anterior tibialis tendon (ATT) allograft has been used for graft for both cases because of other stabilization deficiencies of knees. It has been confirmed that femoral and tibial tunnels constructed with anatomic double-bundle technique are fitting to anatomic locations by the post-operation CT results. Post fixation screw has been used for tibia, and endobutton at femur.
Tracking records of patients at 8th month shows that; Lysholm score of the case aged 20 was 89, and 85 for the case aged 36. While KT-1000 values was 3.7 mm, and 4.1 mm for 15 N power; and 9.1 mm-9.6 mm with the maximum power.
Surgical technical details of one-staged double-bundle reconstruction for ACL and PCL injuries which is gaining popularity recently has been stated.
严重膝关节脱位的主要证据是前交叉韧带(ACL)和后交叉韧带(PCL)均断裂。同时治疗这两条韧带的资源有限。材料与方法:一期解剖双束ACL和PCL重建技术应用于2例年龄分别为20岁和36岁的创伤性膝关节脱位患者。其中1例增加了外侧副韧带和后外侧角重建,另1例增加了内侧副韧带和后内侧角重建。由于两例患者均合并股骨骨折,韧带重建在主要治疗后进行。由于膝关节存在其他稳定缺陷,两例均采用胫骨前肌腱(ATT)同种异体移植物作为移植物。术后CT结果证实,采用解剖双束技术构建的股骨和胫骨隧道与解剖位置相符。胫骨使用后置固定螺钉,股骨使用纽扣钢板。
患者8个月的随访记录显示,20岁患者的Lysholm评分为89分,36岁患者为85分。15 N力量下KT-1000值分别为3.7 mm和4.1 mm;最大力量下为9.1 mm - 9.6 mm。
阐述了近期日益流行的ACL和PCL损伤一期双束重建的手术技术细节。