Ligament Augmentation as a Treatment for Partial Anterior Cruciate Ligament Injury with Bone-Patellar Tendon-Bone Autograft: Case Report

Abstract

Anterior cruciate ligament (ACL) rupture is one of the most common knee injuries in young active patients, negatively impacting their sports activity. Clinical presentation typically includes a history of trauma accompanied by edema, pain, functional limitation, and a sense of joint instability. There are various clinical signs and MRI findings suggestive of the injury, although arthroscopy remains the definitive diagnostic method. Treatment goals aim to achieve optimal rehabilitation and functional recovery, early return to sports, and prevention of joint damage that could lead to premature knee degeneration. In partial tears, there is no consensus on whether to preserve the remaining bundle or perform total ligament reconstruction. Regarding the choice of surgical technique, anatomical reconstruction has been preferred, and for graft selection, autograft has been chosen, although there are different valid therapeutic options based on each patient's characteristics. This review presents the case of a 36-year-old male diagnosed with a partial ACL tear with an intact posterolateral bundle, following an axial load injury mechanism with the knee in flexion, clinically presenting with pain, limited mobility, and joint instability of the knee. Due to the patient's clinical and imaging characteristics, arthroscopy was chosen as the diagnostic and therapeutic method. Based on arthroscopic findings, ligament augmentation with a bone-patellar tendon-bone autograft was performed, due to the mechanical advantages of the anatomical positioning of the bone tunnels offered by the surgical technique, as well as the biological advantages, such as preservation of joint proprioception, bone integration, and functional benefits of graft selection.

Keywords

anterior cruciate ligament - ligament augmentation - autograft - bone-tendon-bone graft - arthroscopy

Ethical Considerations

It was not experimented on any patient; it was only the presentation of a clinical case.

Servicio de Traumatología y Ortopedia del Hospital Español, Ciudad de México, México.

Publikationsverlauf

Eingereicht: 24. September 2024

Angenommen: 06. November 2024

Artikel online veröffentlicht:
26. Dezember 2024

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