Cruciate Ligaments Surgery

Anterior cruciate ligament rupture results in knee instability or the premature wear of the menisci, a potential source of early osteoarthritis in young patients. Arthroscopic reconstruction of the anterior cruciate ligament using a short graft of the semitendinosus tendon (4-strand semitendinosus autograft) is a reliable, proven method for stabilising the knee and enabling a return to the same level of sports activity as before. This technique has the advantage of using only one tendon with excellent mechanical strength and very low donor site morbidity.

Anterior cruciate ligament rupture results in knee instability or the premature wear of the menisci, a potential source of early osteoarthritis in young patients. Arthroscopic reconstruction of the anterior cruciate ligament using a bone-tendon-bone graft of the patellar tendon (Kenneth-Jones technique) is a tried and tested method for stabilising the knee and enabling a return to the same level of sports activity as before. This technique is often a cause of transitory anterior discomfort around the harvest site of the tendon graft and is currently used as a second-line treatment when the hamstring tendons have already been harvested.

Posterior cruciate ligament rupture is rare and is caused by a direct trauma on the anterior side of the knee. If the peripheral ligaments are involved, it is essential posterior cruciate ligament reconstruction is performed relatively urgently. However, with an isolated posterior cruciate ligament tear, reconstruction is only necessary in the chronic phase in the case of knee instability or patellar pain. Arthroscopic posterior cruciate ligament reconstruction is achieved using a tendon autograft or in some cases, rapidly after the rupture, using a synthetic graft (LARS artificial ligament).

In approximately 5% of cases, an anterior cruciate ligament ligamentoplasty will rupture and it is sometimes necessary to reconstruct the anterior cruciate ligament again. This iterative arthroscopic ligamentoplasty is more complex as it must take into account the tendon grafts available and the position of the bone tunnels created during the first ligamentoplasty. It is also recommended, if it was not done during the first ligamentoplasty, to combine the intra-articular reconstruction of the anterior cruciate ligament with an extra-articular plasty of the anterolateral ligament to reduce the risk of another ligament tear