Combined reconstruction of the posterior cruciate ligament and medial collateral ligament using a single femoral tunnel

Knee Surg Sports Traumatol Arthrosc. 2017 Oct;25(10):3024-3030. doi: 10.1007/s00167-016-4071-8. Epub 2016 Mar 21.

Abstract

Purpose: Lesions of the medial collateral ligament (MCL) are the most common knee ligament injuries, and lesions associated with the anterior cruciate ligament or the posterior cruciate ligament (PCL) in knee dislocations should be reconstructed to prevent failure of the central pivot reconstruction. The purpose of this study was to evaluate the outcomes of combined PCL/MCL reconstruction using a single femoral tunnel with a minimum 2-year follow-up.

Method: A retrospective study of thirteen patients with combined PCL/MCL injuries was conducted. The patients underwent PCL and MCL reconstruction using an Achilles tendon allograft with a single tunnel in the medial femoral condyle, thereby avoiding tunnel conversion.

Results: All patients achieved a range of motion of at least 100°. The mean loss of extension and flexion values compared to the contralateral side was 1° ± 2° and 9° ± 10°, respectively. Our results included 26 reconstructions with three (11.5 %) failures, two in the PCL (15.3 %) and one in the MCL (7.6 %), in three different patients. In the final evaluation, the mean IKDC subjective score was 71.63 ± 16.23, the mean Lysholm score was 80.08 ± 13.87, and the median Tegner score was 6 (range = 2-7).

Conclusion: The PCL/MCL reconstruction technique using a single femoral tunnel and an Achilles tendon allograft is safe, avoids the convergence of tunnels in the medial femoral condyle, has excellent results, and is reproducible.

Level of evidence: IV.

Keywords: Achilles tendon; Dislocation; Knee; Medial collateral ligament; Technique.

MeSH terms

  • Achilles Tendon / transplantation
  • Adolescent
  • Adult
  • Female
  • Femur / surgery*
  • Follow-Up Studies
  • Humans
  • Knee Injuries / surgery*
  • Male
  • Medial Collateral Ligament, Knee / injuries*
  • Medial Collateral Ligament, Knee / surgery
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Posterior Cruciate Ligament / injuries*
  • Posterior Cruciate Ligament / surgery
  • Retrospective Studies
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult