Surgical approach on combined chronic patellar tendon and bicruciate knee ligament injury

TL;DR

This paper discusses the surgical treatment of a rare and complex knee injury involving the patellar tendon and cruciate ligaments.

Contribution

The paper provides a surgical approach based on biomechanical understanding for two-stage reconstruction of combined knee injuries.

Findings

Combined injury affects knee kinematics and biomechanics, requiring careful surgical decision-making.

The manuscript emphasizes the importance of reconstructing structures in a specific order during two-stage procedures.

Surgical success depends on graft selection, fixation, and rehabilitation protocols.

Abstract

A combined injury of the patellar tendon and both the anterior and posterior cruciate ligaments is disabling. It directly affects knee kinematics and biomechanics, presenting a considerable surgical challenge. In this complex and uncommon injury, decision-making should take into account the surgeon’s experience and consider one- or two-stage surgery, tendon graft, graft fixation, and rehabilitation protocol. This manuscript discusses the surgical approach based on a comprehensive understanding of the patellar tendon and bicruciate biomechanics to guide which structures should be reconstructed first, especially when a two-stage procedure is chosen.

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