关键词: 膝关节；韧带, 关节；修复外科手术；治疗结果

Abstract:

Objective　To explore the short-term clinical outcome of one-stage arthroscopically assisted anterior，posterior and lateral collateral ligament reconstruction and medial collateral ligament（MCL） repair in multiligament knee injuries（MKI），aiming to provide a reference for clinical diagnosis and treatment of this disease.Methods　Totaled 29 cases of MKI（type KD Ⅱ-Ⅳ by Schenck classification） were included from the First Affiliated Hospital of Guangxi Medical University from December 2011 to July 2014.All of them were treated by one-stage arthroscopic surgery：under general anesthesia，arthroscopic examination and debridement were performed through both the medial and lateral approaches；the anterior cruciate ligament（ACL） was reconstructed with the hamstring tendon of the contralateral knee，the posterior cruciate ligament（PCL） and lateral collateral ligament（LCL） were reconstructed with the allogeneic tendon，and the MCL was repaired by suture anchors.In addition，all the cases received individualized rehabilitation trainings.The indicators for evaluating the short-term outcome include postoperative incidence of complications，follow-up results，anterior drawer test（ADT），posterior drawer test（PDT），Bohler sign，Lysholm knee score，IKDC score and range of motion.Results　All the cases were followed up for a mean of（18.5±5.4）（range，12-36） months.During which，the surgical incision of all cases healed by first intention，without infection，osteofascial compartment syndrome，vascular nerve injury associated with surgery or other complications；good range of motion，and good anterior-posterior-lateral stability of the knee were achieved in all cases（as of the last follow-up）.Although postoperative knee joint adhesions occurred in 2 cases，normal range of motion was achieved in 1 after standardized rehabilitation training，and was also achieved in other 1 who was unresponsive to a 3-month rehabilitation training but then received the arthroscopic knee adhesions lysis.Positive results of ADT，PDT and Bohler sign at baseline became negative，and Lysholm knee score，IKDC score and range of motion at baseline were all improved significantly as of the last follow-up（P<0.05）．Conclusion　For MKI，using one-stage arthroscopic surgery to reconstruct both ACL ，PCL and LCL and to repair the MCL can achieve good stability of the knee and significantly improved knee function.

Key words: Knee；Ligaments, articular；Reconstructive surgical procedures；Treatment outcome