Mid-long Term Postoperative Follow-up Of Arthroscopic Repair And Reconstruction For Multiple Ligament Injuries Of Knee

Objective:To describe the clinical effect of arthroscopic repair and reconstruction of multiple ligament injuries of knee.And compare the postoperative evaluation of knee joint function between early-stage group and deferred-stage groupMethods:From January 2006 to December 2015,23 patients(16 males and 7 females,with age ranging from 18 to 58 years old,the average age is 36 years old)with multiple ligament injuries of knee accepted arthroscopic reconstruction and repair.Twelve patients accepted operation in early-stage and others accepted operation in deferred-stage.Six patients were treated with arthroscopic reconstruction of anterior cruciate ligament(ACL)and repair of medial collateral ligament(MCL).Four patients were treated with arthroscopic reconstruction of combined ACL and posterior cruciate ligament(PCL)and repair of MCL.Seven patients were treated with arthroscopic reconstruction of combined ACL and PCL.Two patients were treated with arthroscopic reconstruction of ACL and repair of lateral collateral ligament(LCL).Two patients were treated with arthroscopic reconstruction of combined ACL and LCL.One patient was treated with arthroscopic reconstruction of combined ACL and MCL.One patient was treated with arthroscopic reconstruction of combined ACL?PCL and LCL.The International Knee Documentation Committee(IKDC)?Tegner and Lysholm score were used to evaluate the postoperative clinical result.Result:All patients were followed up for 13 to 122 months with an average of 54.6 months.One patient complained the range of motion(ROM)of knee was limited slightly.Fourteen patients felt pain occasionally,three patients' knee will swell when they exercise drastically and eight patients' knee will be unstable when they exercise.All patients did not suffer severe complication such as rupture of graft.The average of preoperative IKDC score of all cases is(31.5 ± 10.5)and(79.6 ± 11.0)at final followed up(t=16.836 p<0.01).The average of preoperative Lysholm score is(37.9± 11.9)and(89.6±8.3)at final followed up(t=16.089 p<0.01).The average of preoperative Tegner score is(0.9±0.7)and(4.0±0.8)at final followed up(t=15.486 p<0.01).The success rate of postoperative IKDC score is 69.6%.There is significant statistically difference between preoperative and postoperative in those score.The success rate of patients who injury 2 ligaments is 91.7%.The success rate of patients who injury more than 2 ligaments is 45.5%.There is significant statistically difference between these two group.The success rate of patients who are elder than 50 is 0%.There is significant statistically difference between age groups.The success rate of postoperative IKDC score is 82.6%.There is not significant statistically difference between groups.Conclusion:1?Single-stage arthroscopic repair and reconstruction of multiple ligaments injuries of knee can effectively improves the function of knee joint and it is a valid method for the treatment of multiple ligaments injury of knee.2?There are no difference in postoperative evaluation of knee joint function between early-stage group and deferred-stage group.Doctors should choice the correct surgery timing according to practical situation such as the swollen degree of knee joint to process the single-stage operation.3?The postoperative success rate is not be affected by the sex of patients and the years of fellow up.The age of patients and the amount of injuried ligaments can influence the curative effect.