2017 ISAKOS Biennial Congress IFOSMA ePoster #5015

 

2 Failed Cases Of Ligament Reconstruction Of The Knee

Sheng Zhang, PhD, Beijing CHINA
Lei Zhang, MD, PhD, Beijing CHINA

Wangjing Hospital of CACMS, Beijing, Beijing, China

FDA Status Not Applicable

Summary

Report 2 failed cases of ligament reconstruction of the knee

ePoster Not Provided

Abstract

we report 2 failed cases of ligament reconstruction of the knee. Case presentation: A 24 years old male, fell off from the high scaffold and was transferred to a local ER at time zero. The medial tibial plateau fracture & cruciate ligaments injury of left knee were diagnosed, and a plaster slab was prescribed for 2 months. After the plaster was removed, the patient accepted the rehabilitation protocol. Because of the constant unstable left knee, the patient revisited previous hospital and underwent ACL reconstruction surgery. However, the patient still complained left knee unstable 4 months after the ACL surgery, so he came to our institution. During the physical examination, posterior instability was presented. We thought that the local surgeon missed the torn PCL, so we did PCL reconstruction. During the arthroscopic procedure, we saw a vertical ACL graft & the torn PCL. Because of negative ADT, so we did PCL reconstruction. At time zero we got a very stable knee. However, the patient revisited to our institution 3 months after the surgery, he complainted mild instability and I degree posterior drawer laxity was presented during the physical examination. But the MRI showed PCL graft was quite good. 9 months after PCL surgery, the patient complained obvious instability, and re-admit to our institution. A 48 years old female got her right knee injured during a traffic accident. She was transferred to local ER immediately. The X ray indicated right knee was dislocated, and reduced in the ER and immobilised with a locking brace. 4 days later, she came to our institution. According to the physical examination, CT & MRI scan, the PCL & PLC injury were presented, so we did PCL & PLC reconstruction with artificial ligament. At time zero we got a very stable knee. However, she revisited to our institution 6 moths after the surgery, she complainted constant right knee pain and unstable, a double varus knee was presented during the physical examination. We reviewed the 2 failed cases and found that they had something in common : 1.both of the patient had midl medial tibial plateau collapse, which resulted in varus deformity of the lower extremity and put excessive load to the lateral structures. 2. both of the tibial slop of the patients were decreased because of the tibial fracture which may put PCL graft in danger. Conclusion: The osseous deformities were important for the success of ligament reconstruction of the knee.