«Reconstrucción artroscópica simultánea de las lesiones crónicas anteriores y posteriores del ligamento cruzado.»
Denti, Matteo MD; Volpi, Piero MD; Schonhuber, Herbert MD; Bait, Corrado MD; Lo Vetere, Dario MD
Combined ACL and PCL chronic lesions can be treated arthroscopically, preferably with a double ST-GR autograft for ACL and BPTB autograft for the PCL reconstruction. We describe the steps involved in performing this type of arthroscopic surgery using a PCL reconstruction with the 2-incision technique and an ACL reconstruction with the 1-incision technique. The steps are (1) diagnosis and treatment of associated lesions, (2) harvesting of ipsi- or contralateral tendon grafts, (3) removal of the PCL and ACL stumps, (4) reconstruction of the PCL (tibial tunnel and femoral tunnel positioning of the femoral tunnel guide wire), (5) reconstruction of the ACL (intercondylar notchplasty, tibial tunnel, and femoral tunnel), (6) PCL femoral tunnel, and (7) insertion and fixation of the grafts. A severe peripheral instability (usually posterolateral) requires the reconstruction of this portion before the intra-articular treatment. Patients are nonetheless advised that the purpose of the operation is to eliminate or reduce everyday instability and resume low- and moderate-impact sports.
Techniques in Knee Surgery. 3(3):138-144, September 2004.