Lubis Andri M T, Aprilya Dina, Tania Kanya
Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Indonesia.
Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Indonesia.
Int J Surg Case Rep. 2020;76:81-84. doi: 10.1016/j.ijscr.2020.09.136. Epub 2020 Sep 23.
Anterior cruciate ligament (ACL) rupture is a common injury in young and active population and reconstruction is the mainstay treatment to maintain stability of the knee. Hamstring tendon (HT) is the most popular graft for ACL reconstruction. In certain patient, particularly in women, the size of tendon graft to reconstruct the ACL is unpredictable. In the case of unqualified donor, we need a combined graft from another source to match the size requirement.
We present two cases of ACL reconstruction using combination of HT and PLT graft in adolescent female. We evaluate knee functional score and ankle donor site morbidity. In the second case we also did second look for the ACL graft integrity arthroscopically. This study has been reported in line with the Surgical Case Report (SCARE) criteria.
One year after surgery, International Knee Documentation Committee (IKDC) score for both cases were improved and no ankle-donor site morbidity with good motoric power and 100% American Orthopedic Foot Ankle Score (AOFAS).
Additional peroneus longus tendon can be considered as an alternative in undersized hamstring tendon graft without significant donor site morbidity.
前交叉韧带(ACL)断裂在年轻活跃人群中是一种常见损伤,重建是维持膝关节稳定性的主要治疗方法。腘绳肌腱(HT)是ACL重建最常用的移植物。在某些患者中,尤其是女性,用于重建ACL的肌腱移植物大小不可预测。在供体不合格的情况下,我们需要来自其他来源的联合移植物以满足大小要求。
我们展示了两例青少年女性使用HT和PLT移植物联合进行ACL重建的病例。我们评估了膝关节功能评分和踝关节供体部位的并发症。在第二例病例中,我们还通过关节镜对ACL移植物完整性进行了二次检查。本研究已按照外科病例报告(SCARE)标准进行报告。
术后一年,两例病例的国际膝关节文献委员会(IKDC)评分均有所改善,踝关节供体部位无并发症,肌力良好,美国矫形足踝协会(AOFAS)评分为100%。
在腘绳肌腱移植物尺寸不足时,可考虑加用腓骨长肌腱作为替代方案,且供体部位并发症不明显。