Murakami Ryo, Honda Eisaburo, Fukai Atsushi, Yoshitomi Hiroki, Sanada Takaki, Iwaso Hiroshi
Department of Sports Orthopedic Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kawasaki City, Kanagawa Prefecture, Japan.
Case Rep Orthop. 2020 Feb 24;2020:7348201. doi: 10.1155/2020/7348201. eCollection 2020.
Till date, there are no clear guidelines regarding the treatment of multiple ligament knee injuries. Ligament repair is advantageous as it preserves proprioception and does not involve grafting. Many studies have reported the use of open repair and reconstruction for multiple ligament knee injuries; however, reports on arthroscopic-combined single-stage anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) repairs are scarce. In this report, we describe a case of type III knee dislocation (ACL, PCL, and medial collateral ligament (MCL) injuries) in a 43-year-old man, caused by contact while playing futsal. On the sixth day after injury, arthroscopic ACL and PCL repairs were performed with open MCL repair. The proximal lesions in the three ligaments that were injured were sutured using no. 2 strong surgical sutures. The ACL was pulled out to the lateral condyle of the femur and fixed using a suspensory fixation device. The PCL was pulled out to the medial condyle of the femur, and the MCL was pulled towards the proximal end of the femur; both were fixed using suture anchors. Early mobilization was performed, and both, clinical and imaging outcomes, were good two years after surgery.
迄今为止，对于膝关节多发韧带损伤的治疗尚无明确的指导方针。韧带修复具有优势，因为它能保留本体感觉且无需进行移植。许多研究报道了采用开放修复和重建治疗膝关节多发韧带损伤；然而，关于关节镜下联合单阶段前交叉韧带（ACL）和后交叉韧带（PCL）修复的报道却很少。在本报告中，我们描述了一例43岁男性因踢室内五人制足球时受到碰撞导致的III型膝关节脱位（ACL、PCL和内侧副韧带（MCL）损伤）病例。受伤后第六天，进行了关节镜下ACL和PCL修复以及开放MCL修复。使用2号强力手术缝线缝合三根受损韧带的近端损伤部位。将ACL拉至股骨外侧髁并用悬吊固定装置固定。将PCL拉至股骨内侧髁，将MCL拉向股骨近端；两者均使用缝合锚钉固定。术后进行了早期活动，术后两年临床和影像学结果均良好。
