Concomitantly combined ACL and PLC reconstruction: Case report and literature review

Abstract

Introduction: : Injuries involving the posterolateral ligamentous system occur in approximately 7 – 16% of knee ligament injuries. However, only 28% of all posterolateral corner (PLC) injuries are alone and usually combined with cruciate ligament injury (posterior cruciate ligament-PCL > anterior cruciate ligament-ACL). Combined ACL and PLC tears account for 10% of complex knee injuries. An unaddressed posterolateral corner injury may be a leading cause of ACL reconstruction failure.

Case presentation: A 26 year old male patient with combined ACL and PLC injury. He was concurrently reconstructed by both ACL and PLC. We used 2 semitendinosi (1 in each knee) and 1 gracilis tendon (in the injured knee). The ACL was reconstructed by one stranded semitendinosus with all-inside technique and Tightrops fixation. The PLC reconstruction utilized one femoral tunnel at the isometric point, graft fixation at the femoral tunnel by tightrope, and at the tibial tunnel by absorbable screw. At the 9 months follow-up, the Cincinnati score was 70/100 and the IKDC score was B type.

Conclusions: Concomitantly combined ACL and PLC reconstruction has good results in remaining knee functions and decreasing ACL reconstruction failure. However, femoral tunnel creation needs to avoid femoral tunnel intersection.

Keyword: ACL and PLC combined reconstruction, Posterolateral corner.

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