A case report of anterior cruciate ligament and posterolateral corner reconstruction using tendon graft preserved in situ

Feb 17, 2018; International Journal of Surgery. https://dx.doi.org/10.1016%2Fj.ijscr.2018.02.018

Abstract

Introduction
Combined anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstruction are a rare clinical entity in orthopedic literature, whose management requires different types of tendon grafts. Missed PLC injury leads to the failure of ACL repair due to the joint instability.

Presentation of case
We are presenting a case of posttraumatic right ACL, PLC and lateral meniscus injury. The patient was taken to theatre for arthroscopic meniscectomy, ACL and PLC reconstruction. We had to harvest bilateral Gracilis and semitendinosus tendon grafts. Intraoperatively, we used a pump and after meniscectomy and ACL reconstruction the knee was quite swollen; we opted to offer a two-staged procedure for PLC reconstruction. Hence we had to preserve the graft in situ for the next procedure. Posterolateral corner reconstruction was done in a week’s time and preserved ligament was found to be intact.

Discussion
The fact that we did not have a tissue bank or facilities for cryopreservation of the harvested tendons at −80 °C or with liquid nitrogen at −179 °C yet we had to keep the harvested tendons safe.

Conclusion
In case of absence of graft and bone bank, tendon graft was in situ and found intact and ready to be used after seven days.

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