Late patellar ligament reconstruction for anterior cruciate ligament rupture

Anterior cruciate ligament rupture with advanced patellar ligament reconstruction for surgical treatment of knee cruciate ligament injury. Knee ligament rupture is one of the most common serious injuries in the knee joint. The cruciate ligament can be a simple injury, but often accompanied by other ligament injuries, the most common is the injury of the collateral ligament. Early correct repairs are generally satisfactory. Reconstruction of the advanced cruciate ligament injury, due to the patient's multiple rotation instability, the reconstructed ligament can not reach the normal anatomical state, and gradually become slack after surgery, the effect is not satisfactory. Treatment of diseases: knee joint ligament injury knee joint collateral ligament fracture knee joint collateral ligament injury Indication The anterior cruciate ligament rupture of the anterior cruciate ligament is suitable for anterior and lateral ligament injury. Surgical procedure Incision Make a anterior median straight incision, or anterior medial incision, from 2.5 cm above the tibia to 2.5 cm below the tibial tuberosity. 9.2 2. Cutting the patellar ligament Cut the skin, under the skin, reveal the patellar ligament, design the ligament strip 13~15cm long from 5cm to the tibial tuberosity. The width of the strip is about 1/3 of the width of the patellar ligament. The humerus cortex should be attached to the iliac crest. The osseous cortex is usually cut from the front with a bone knife, and a few tibial tuberosity cortical cortex is removed at the distal end to form a patellar ligament strip connected to the distal tibial tuberosity. 9.3 3. Check the joint cavity The joint cavity is exposed, the humerus is pushed to the outside, the knee joint is slightly flexed, the intercondylar notch is revealed, the torn meniscus is removed, and the anterior cruciate ligament stump is sought. If the stump is short, it needs to be removed. 9.4 4. Fixing the ligament strip The bone is drilled by hand at the exfoliation of the tibial tuberosity, and a bone hole is drilled obliquely to the intercondylar bulge (the anterior cruciate ligament attachment portion), and the bone hole is enlarged by the bone cone, and the patellar ligament strip is fed into the joint through the bone hole. Then make a mouth on the outer side of the femoral condyle, extending approximately 10 cm from the Gerdy nodule to the proximal side. The fascia is cut open, the lateral head of the gastrocnemius is separated, and the blunt dissection separates the gap from the posterior side. The curved vascular clamp was used to pass back through the intercondylar notch and bypass the posterior aspect of the lateral femoral condyle to the lateral incision. The proximal end of the free patellar tendon was passed through the perforation, and the part of the patellar ligament with the tibial cortex was placed on the lateral femoral condyle. Under appropriate tension, the posterior part of the femoral condyle was fixed with screws, and the sutures were intermittently surrounded.