Posterior cruciate ligament reconstruction using a septum-preserving technique.

摘要: OBJECTIVE Description of a reproducible surgical technique for single-bundle anterolateral reconstruction the posterior cruciate ligament (PCL) based on a septum-sparing approach. This is less traumatic than trans-septum The article illustrates steps to simplify technical aspects procedure. INDICATIONS A complete grade III symptomatic tear PCL associated with instability and often discomfort (deceleration, stairs) or subsequent gonalgia arising from medial compartment patellofemoral joint. Injury peripheral joint stabilizers alongside including posterolateral corner a complete knee injury. procedure indicated in chronic cases, but also acute cases > 10 mm, if it an intraligamentous dislocated stumps. CONTRAINDICATIONS Bony avulsions suitable refixation, soft tissue compromise, infection, advanced osteoarthritic disease. SURGICAL TECHNIQUE After diagnostic arthroscopy knee, ipsilateral semitendinosus gracilis tendons are harvested prepared as a 6-strand graft reconstruction. One high viewing portal, one low anteromedial a posteromedial portal used via femoral tibial bone tunnel hybrid fixation. POSTOPERATIVE MANAGEMENT Weight bearing restricted 20 kg 6 weeks. brace support a period 12 weeks. Flexion limited 30° first 2 postoperative weeks, then 60° 2 weeks, 90° further weeks. Passive flexion prone position performed. Active focused muscle strengthening exercise begun after 6 weeks postoperatively participation competitive sports not recommended before full strength coordination re-established, at earliest 9-12 months postoperatively. RESULTS Two isolated 19 combined injuries were treated. Mean patient age was 27.4 years, minimal follow-up 12 months. On average, we found good clinical outcome slight degree laxity (4.1 mm) comparison contralateral knee. No showed signs effusion follow-up. Range motion fully restored 21 patients. suffered failure due persistent persistence symptoms.