Multiligament Injury of Knee and ACL & PCL Reconstruction
-
Upload
jahangir-hossain -
Category
Sports
-
view
27 -
download
0
Transcript of Multiligament Injury of Knee and ACL & PCL Reconstruction
ARTHROSCOPIC MULTILIGAMENT – ACL & PCL RECONSTRUCTION IN SINGLE STAGE
Dr. G. M. Jahangir Hossain Assistant Professor
National Institute of Traumatology and Orthopaedic Rehabilitation
Multi ligament knee injury is a complex problem
ACL & PCL with or without other ligament injury
High-velocity injury – MCA, fall from height
Low-velocity injury – Twisting and contact sports
Associate with fracture and neurovascular injury
MULTI LIGAMENT KNEE INJURY : LITERATURE REVIEW
PCL : Double bundle
AL bundle - tighten in flexion - loosen in extension
PM bundle - tighten in extension - loosen in flexion
AL b
undl
e
PM b
undl
e
AM bundle - tighten in Knee flexion - loosen in knee extension - limits anterior tibial translation
PL bundle - tighten in knee extension - loosen in flexion - limits tibial internal rotation
Sagittal T2 weight Image
● Disorganisedly oriented● Altered signal intensity
STRESS X-RAY KNEE : PTT
ARTHROSCOPIC VIEW OF ACL AND PCL
INTACT ACL & PCLVIDEO : INJURED ACL & PCL
● Hamstring tendons from ipsilateral and opposite side● Anatomic single bundle ligament - fixed with bioscrews ● Transtibial PCL recons with help of C-ARM ● Combined ACL & PCL in 7 male patients with minimum f/up 6 months and maximum 30 months
Reconstruction of ACL and PCL
ANTERIOR AND POSTERIOR TIBIAL TRANSLATION
TRANSTIBIAL TUNNEL TECHNIQUE FOR PCL
C-arm to check Zig and guide wire placement for Tibial Tunnel
PM portal
Tibial Tunnel for PCL
RECONS ACL & PCL
6 months after ACL & PCL reconstruction
PRE OP AP TT
POST OP AP TT
POST OP
CONCLUSION
ACL & PCL reconstruction -Stability of the jointRegain normal range of motionRestoration function of the jointReturn to preinjury level of activity
When, MCL, LCL and PLC are intact or improved preoperatively
THANKS FOR
ATTENTION