Abstract
Introduction & Objectives:
Complex knee injuries involving the anterior cruciate ligament (ACL), anterolateral ligament (ALL), and lateral collateral ligament (LCL) require intricate surgical techniques to restore stability and function. This case report presents a unique approach using a single femoral tunnel for ACL and ALL reconstruction, coupled with LCL reconstruction and meniscus repair.
Case Presentation:
This study is a case report of 22-year-old male presented with a two-year history of right knee pain and instability following badminton injuries. Initial injury caused pain and swelling, but the patient did not seek treatment until re-injury occurred, exacerbating symptoms. Clinical examination revealed positive Lachmann, pivot shift, and varus stress tests. MRI confirmed ACL and LCL ruptures, and medial and lateral meniscus tears. The patient underwent ACL and ALL reconstruction using a single femoral tunnel with a peroneus longus autograft, LCL reconstruction using semitendinosus and gracilis autografts, lateral meniscus repair, and medial meniscectomy. Postoperatively, the knee was immobilized in 0-degree extension with gradual flexion exercises.
Results:
After a period of three months following the surgical procedure, patient achieved a knee flexion range of 140 degrees and successfully resumed his work activities. The ALL is critical for rotational knee stability, often compromised following ACL injuries, leading to anterior tibial subluxation. LCL injuries, although rare, significantly impact knee stability. The single femoral tunnel technique reduces femoral weakening and improves stability, showing better outcomes in chronic ACL injuries.
Conclusion:
The described approach of using a single femoral tunnel for ACL and ALL reconstruction, alongside LCL reconstruction and meniscus repair, effectively addresses complex knee instability while minimizing femoral weakening and restoring knee function.