All-Inside Bicruciate Ligament and Open Posterolateral Corner Reconstruction With Suture Augmentation.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Multiligamentous knee injuries (MLKIs) are severe, traumatic conditions requiring intricate surgical interventions for joint stabilization.
• This study addresses novel techniques for posterolateral corner (PLC) reconstruction, specifically within the context of bicruciate ligament reconstruction.

Purpose of the Study:

• To outline innovative surgical techniques for PLC reconstruction combined with suture augmentation in cases of bicruciate knee injuries.
• To detail the management of a specific MLKI case, a Schenck knee dislocation class III-L, in a 65-year-old patient.

Main Methods:

• Reconstruction involved all-inside tunnels and allograft usage for both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL).
• A modified open Arciero technique was employed for PLC reconstruction, utilizing a single continuous allograft for the lateral collateral ligament (LCL) and popliteus.
• Suture augmentation was applied to the LCL to prevent graft stretching, with PCL fixation preceding ACL and PLC fixation.

Main Results:

• Postoperative progress at 6 weeks included restored passive range of motion and tolerance of partial weight-bearing.
• Full recovery is anticipated within 9 to 12 months, aligning with standard MLKI recovery protocols, assuming no complications.

Conclusions:

• The study describes a specific surgical approach for a complex MLKI with concomitant PLC reconstruction.
• Further research is needed to establish optimal reconstruction strategies for MLKIs, particularly those involving combined injuries.