ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Single Femoral Tunnel For PCL And MCL Reconstruction Using Autografts- 2 Year Follow Up

Munis Ashraf Keyi, MBBS, DNB (Orth), FASM, FSRM, Chennai, Tamil Nadu INDIA
Santosh Sahanand Kulasekaran, MBBS,MS(ortho), Chennai, Tamilnadu INDIA
David V. Rajan, MS(Orth), MNAMS(Orth), FRCS(G), Coimbatore, Tamil Nadu INDIA

Ortho One Orthopaedic Speciality center, Coimbatore, Tamil Nadu, INDIA

FDA Status Not Applicable

Summary

This is a 2 year follow up study which reports a favourable outcome with regards to the use of single femoral tunnel in the medial condyle for PCL and MCL reconstruction thereby reducing the chance of tunnel divergence and multiple bone tunnels

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Abstract

Purpose

Multiligament injuries of the knee require multiple bony tunnels for the ligamentous reconstruction. In this paper, we present a technique of using single femoral tunnel for the PCL and MCL reconstruction and thereby minimising the tunnel convergence.The study aims to evaluate the outcomes of combined PCL/MCL reconstruction using a single femoral tunnel with a minimum 2-year follow-up.

Method

A retrospective study of eight patients (16 reconstructions) with combined PCL/MCL injuries was conducted. The patients underwent PCL and MCL reconstruction using a single tunnel in the medial femoral condyle. Contralateral central quadriceps tendon graft for the PCL and ipsilateral semitendinosus graft for MCL was used.

Statistical analysis:
Means, standard deviations, and frequencies were calculated for the demographic data, range of motion and the results of the subjective questionnaire analysis. A Shapiro-Wilk test was used to verify the normal distribution of data. A paired Student t test was used to compare preoperative and postoperative IKDC subjective scores, Lysolhm Tegner score. Statistical analyses were made using the SPSS Statistical Package for Social Sciences (v18.0).

Results

The average range of motion was 112.5 ± 18.5 (p value <0.001) at the end of 24 months. Our results included 16 reconstructions with one failure in the MCL, and none in the PCL. At the end of 24 months, the mean IKDC subjective score was 65.8 ± 6.3 (p value <0.001), the mean Lysholm score was 83.5 ± 7.7 (p value <0.001). The results were statistically significant using the two tailed paired t test.

Conclusion

The PCL/MCL reconstruction technique using a single femoral tunnel with autograft ( Contralateral central quadriceps tendon graft for the PCL and ipsilateral semitendinosus graft for MCL) is safe, avoids the convergence of tunnels in the medial femoral condyle, has excellent results, and is reproducible.

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