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多韧带膝关节损伤的关节镜综合治疗:病例报告

Comprehensive Arthroscopic Management of Multi-ligament Knee Injury: A Case Report.

作者信息

Pugazhendhi G, Aravindan M, Kumar M Navin, Shankaran G B Shiva

机构信息

Department of Orthopedics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India.

出版信息

J Orthop Case Rep. 2025 May;15(5):190-197. doi: 10.13107/jocr.2025.v15.i05.5608.

Abstract

INTRODUCTION

Multi-ligament knee injuries (MLKIs), involving damage to two or more major knee ligaments, present complex challenges in orthopedic surgery due to the intricacy of the injury and its significant impact on knee stability and function. These injuries often require specialized treatment strategies, with two-stage surgical reconstructions emerging as a viable option. This report examines a case of MLKI and the outcomes of a staged surgical approach to repair and reconstruct the affected knee ligaments.

CASE REPORT

A 55-year-old female sustained a multi-ligament injury to her right knee after a twisting event, resulting in pain, swelling, and instability. The patient underwent a two-stage arthroscopic reconstruction, beginning with repair of the posterior cruciate ligament and posterolateral corner structures, followed by anterior cruciate ligament reconstruction. Autografts, including the bilateral peroneus longus and contralateral hamstrings, were used for the procedure. Her rehabilitation protocol emphasized early passive range of motion exercises, with delayed weight-bearing to promote effective healing.

CONCLUSION

This case demonstrates the successful restoration of knee stability and function following a two-stage surgical approach to MLKI. The case underscores the need for individualized treatment plans and highlights the potential benefits of a phased procedure. While promising, further research is required to compare single-stage and two-stage approaches and to assess their long-term outcomes in managing complex MLKIs.

摘要

引言

多韧带膝关节损伤(MLKIs)涉及两条或更多主要膝关节韧带的损伤,由于损伤的复杂性及其对膝关节稳定性和功能的重大影响,给骨科手术带来了复杂的挑战。这些损伤通常需要专门的治疗策略,两阶段手术重建已成为一种可行的选择。本报告研究了一例多韧带膝关节损伤病例以及采用分阶段手术方法修复和重建受影响膝关节韧带的结果。

病例报告

一名55岁女性在一次扭转事件后右膝遭受多韧带损伤,导致疼痛、肿胀和不稳定。患者接受了两阶段关节镜重建手术,首先修复后交叉韧带和后外侧角结构,随后进行前交叉韧带重建。手术中使用了自体移植物,包括双侧腓骨长肌和对侧腘绳肌。她的康复方案强调早期被动活动度练习,并延迟负重以促进有效愈合。

结论

本病例证明了采用两阶段手术方法治疗多韧带膝关节损伤后膝关节稳定性和功能的成功恢复。该病例强调了个性化治疗计划的必要性,并突出了分阶段手术的潜在益处。虽然前景乐观,但仍需要进一步研究来比较单阶段和两阶段手术方法,并评估它们在处理复杂多韧带膝关节损伤中的长期效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef98/12064225/15f129924559/JOCR-15-190-g001.jpg

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