Clinical Efficacy Of Arthroscopic Simultaneous Treatment For Anterior Cruciate Ligament Combined With Medial Collateral Ligament Injury

Objective:To explore the clinical effect of one-stage anterior cruciate ligament reconstruction using remnant preservation by arthroscope and a limited incision to repair medial collateral ligament in the treatment of acute anterior cruciate ligament and medial collateral ligament injury.Methods:Collect the 43 cases of anterior cruciate ligament combined with III°medial collateral ligament of acute injury from March 2015 to May 2017,Department of Orthopectics.All patients were treated within 2 weeks after the injury.The anterior cruciate ligament were reconstructed by means of semitendinosus and gracilis tendons under the arthroscopy,and limited incision of the medial knee at the same time,to repair of the medial collateral ligament.Repair,suture or resection were selected according to the intraoperative meniscus injury.The stability of the knee was assessed according to the results of anterior drawer test,Lachman and Valgus stress test.IKDC,Lysholm and active range of motion were used to evaluate the knee function of patients pre-operation and the last follow up.Results:All 43 patients were followed up 9~24 months,an average of 20.1 months.Last follow-up showed knee active flextion> 120 ° 39 cases.Anterior drawer test was examined in the knee flexion 90 °,preoperative positive in 36 cases,4 suspicious,3negative;at the time of the latest follow-up,positive in 2 cases,41 negative.Lachman had36 preoperative positive cases,3 suspicious,4 negative;1 case of positive and 42 negative cases in the last follow-up.Valgus stress test in the knee flexion 0°,there were 38 preoperative positive cases,5nagative;and 43 cases of negative in the last follow-up.Knee Lysholm score of knee function were(45.7±6.7)preoperatively and(95.2±4.6)at the last follow-up;IKDC scores: preoperative(28.1 ± 5.0),(69.5±7.0)at the time of the lastfollow-up;Range of motion: preoperative(91.7 ± 17.8)°,at the time of the last follow-up(125.5±10.6)°.The differences were statistically significant(P< 0.05),indicating that the function and stability were significantly improved compared with the preoperative.The results were rated excellent and good in 93% of cases.Conclusive:For paitents with acute injury to the anterior cruciate ligament combined with the medial collateral ligament of the knee,using semitendinosus and gracilis tendon reconstruction of anterior cruciate ligament under the arthroscopy and limited incision repair of the medial collateral ligament in the early,not only clear vision,less surgery trauma,and avoid the use of the higher cost of the allograft tendon and rejection,and reduce the incidence of complications;It is helpful for postoperative recovery of knee function and stability.