Multi Ligament (PCL, MCL, LCL, ACL) Reconstruction / Repair)
Ligaments serve as connective tissue bands that link bones together, providing stability to joints. Within the knee joint, four major ligaments play crucial roles: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), and medial collateral ligament (MCL).
A multi-ligament knee injury occurs when two or more ligaments of the knee sustain damage, often stemming from high-energy incidents like motor vehicle accidents, significant falls, or sports activities such as skiing and football.
Reconstructive surgery becomes necessary for multi-ligament knee injuries to repair the damaged tissues and mitigate complications associated with knee instability, such as the development of premature osteoarthritis.
Diagnosis
Accurately identifying which ligaments are torn and the extent of the tears presents the primary challenge in diagnosing patients with multiple ligament injuries.
The diagnostic process typically commences with a thorough clinical assessment conducted by an Orthopaedic surgeon. Key imaging modalities utilized for diagnosis include knee X-rays and MRI scans to provide detailed views of the joint.
Furthermore, functional testing can be carried out during an arthroscopic examination, conducted prior to surgical reconstruction, to corroborate diagnostic findings. These tests may include assessments such as the “gap test,” which measures the space between the femur and tibia.
Certain conditions serve as contraindications for reconstructive knee surgery, including prior knee joint infections, reflex sympathetic dystrophy, complex regional pain syndrome, and severe obesity.
Procedure
During Multiligament Knee Reconstruction surgery, damaged ligaments are repaired using either the patient’s own tissue (autograft) or donor tissue (allograft).
The surgical procedure typically involves arthroscopic techniques, where small incisions are made, and an arthroscope along with specialized instruments are utilized. The surgeon creates tunnels in the thigh and tibia bones using a small drill. Subsequently, grafts are inserted into these tunnels to replace the torn ligaments.
Once the grafts are in place, fixation devices are employed to secure them and maintain ligament stability until the healing process is complete.