Combined ACL -PCL -Medial and Lateral Side Injuries (Global Laxity)

Background: Combined injuries to the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and both the medial and lateral collateral ligaments of the knee represent complex conditions often resulting from high-energy trauma such as sports injuries or accidents. These injuries can lead to significant knee instability, functional impairment, and associated neurovascular complications. The presence of generalized laxity, characterized by hypermobility at various levels, complicates diagnosis and treatment. Effective management requires a thorough understanding of the involved anatomical structures and appropriate surgical techniques to restore knee stability and function. Methods: This study includes a comprehensive review of surgical techniques from ۲۰۰۹ to ۲۰۲۱ for treating combined ACL, PCL, medial collateral ligament (MCL), and lateral collateral ligament (LCL) injuries, along with a retrospective analysis of patients who underwent surgical reconstruction over several years. Preoperative assessments included clinical evaluations and imaging studies such as MRI to confirm ligament injuries and assess joint stability. Surgical methods were primarily arthroscopic, utilizing autologous or allograft tissue for reconstruction. This approach emphasized meticulous graft preparation, optimal tunnel placement for alignment, and mechanical tension to ensure proper ligament function, with standardized postoperative rehabilitation protocols established to facilitate recovery while minimizing complications. Results: The results indicated that surgical intervention for combined ACL-PCL-MCL-LCL injuries yielded promising outcomes in terms of knee stability and functional improvement. In a group of ۴۰ patients, ۸۰% reported significant improvements in knee function, which were assessed using standardized scoring systems such as the Lysholm score and IKDC score at follow-up intervals of ۶ months to ۲ years post-surgery, with minimal complications noted. Only three patients experienced transient neurological irritation, while one patient required additional surgery due to persistent instability. This study demonstrated that early surgical intervention combined with a structured rehabilitation program significantly enhances patient outcomes, particularly in those with severe generalized laxity. Conclusion: Surgical treatment of combined ACL, PCL, MCL, and LCL injuries is crucial for restoring knee stability and function. The findings support the use of arthroscopic techniques in the effective management of these complex injuries, and timely surgical intervention along with comprehensive rehabilitation can lead to favorable outcomes for patients suffering from generalized laxity associated with multiple ligament injuries. Future research is also necessary to focus on refining surgical techniques and examining long-term outcomes to further strengthen treatment protocols. Keywords: Knee Injuries, ACL Reconstruction, PCL Reconstruction, MCL Injury, LCL Injury, Global Laxity, Surgical Techniques, Rehabilitation Outcomes.

کلیدواژه ها:

Knee Injuries ، ACL Reconstruction ، PCL Reconstruction ، MCL Injury ، LCL Injury ، Global Laxity ، Surgical Techniques ، Rehabilitation Outcomes