The Reconstruction And Prognosis Of Multiple Ligament Injury By Arthroscopy

Objective: To investigate the clinical outcomes with early rehabilitationexercise and arthroscopic monitoring in multiple-ligament injury of the kneejoint by reconstruction of the ACL and PCL and repair/reconstruction of theinjured PMC and PLC in one stage.Methods: Collect the18cases of multiple knee ligament injury patients(Schenck type: KD II-Ⅳ type) from December2009to October2013,11males and7females, aged30-47years, mean age40years, taken ACL andPCL reconstruction and PMC and PLC repair or reconstruction. One casewith popliteal artery and common peroneal nerve injury; consolidationmedial meniscus injury10cases, consolidation lateral meniscus injury8cases. All patients take rehabilitative exercises in early post-operation stage.By comparing the IKDC score, Lysholm score and scope of activities toassess efficacy.Results: The18patients were followed up for6to52months, with anaverage follow-up time of30.2months. Sixteen patients can meet their dailylives.PE: The range of motion of injured knees were from0°to120°and140°.ADT(anterior drawer test) and PDT(posterior drawer test) and lachman test were negative. The varus stress test and valgus stress test anddial test were negative. The imaging evaluation: X-ray showed no looseningand shift of screws and mini-plates, the tunnel without expanding; MRI andCT showed no screw loosening, no fractures and ligament rupture and noexpanding tunnel. There are two cases in this group combined flexionlimited whose range of motion of injured knees were90°and100°,within6months after the formal function through training and thephysiotherapy can reach flexion, the movement ranges of the knee were135°. The IKDC scores were（21.7±4.3） preoperatively and（73.2±6.0） atthe final follow-up (P<0.05); Lysholm scores were (26.6±5.2)preoperatively and (77.1±10.5) at the final follow-up; the range of motionwere (65.5±5.5)°preoperatively and (125.0±8.9)°at the final follow-up(P <0.05).Conclusion: The reconstruction of ACL and PCL and one-stage combinedrepairing or reconstructing the PMC and PLC to treat multiple-ligamentinjury by arthroscopy, combined with rehabilitation exercise in earlypost-operation stage has good clinical effects.