Analysis Of Arthroscopic One-stage Repair For Multiple Ligament Injuries Of Knee

Objective: A retrospective analysis of 25 cases of multiple ligament injury of knee joint was made to explore the reasonable treatment and evaluate the short-term effect of arthroscopic repair and reconstruction of multiple ligament injury of knee joint.Methods: Between January 2013 and September 2018,25 cases(25 knees)with multiple ligament injuries of knee were treated with arthroscopic reconstruction and repair in Third Hospital of Hebei Medical University.There were 22 males and 3 females with an average age of 42.2 years(range,18-73 years).Injury was caused by traffic accident in 12 cases,heavy-weight crushing in 2 cases,sports sprain in 10 cases,and falling from height in 1 case.The average time from injury to operation was 12.24 days(range,2-36 days).In these patients,2 had injuries in ACL、PCL、MCL、and LCL,18 had ACL、PCL and MCL injuries,2 had ACL、PCL and LCL injuries,the other 3 cases had ACL、MCL and LCL injuries,including cartilage injury in 5 cases,meniscus injury in 15 cases,fibular head fractures in 2 cases.All patients received one-stage operation under arthroscopy.The range of motion(ROM),Lysholm function score before and after surgery were used to evaluate the clinical result.Results: All patients were followed up for 6 to 36 months with an average of 21.48 months.All of the patient showed improved ROM of knee at the last follow-up.9 patients felt pain occasionally,5 patients’ knees will swell when they exercise drastically and 8 patients’ knees will be unstable when they exercise or walk long distance.All patients did not suffer severe complication such as rupture of graft and infection.The average of preoperative Lysholm score was(23.2±6.9)and the ROM was(49.8±24.4)°.At the last follow-up the average of Lysholm score was(85.7±3.8);and the ROM was(121.5±5.1)°,all showing significant differences when compared with preoperative ones(t=-47.2,P<0.05;t=-14.427,P<0.05).Conclusions: For patients with multiple ligament injuries of the knee joint,we recommend early(about 2 weeks after injury)arthroscopic repair and reconstruction with autogenous or allogenic tendons,which can achieve good short-term clinical efficacy and significantly improve the function of the knee joint.For patients with PCL injury,sufficient strength of the graft should be guaranteed during the operation and special brace fixation should be applied after reconstruction to prevent the failure of the graft due to tibial sinking,and the recovery process should be slowed down relatively.