Skip to main content
SpringerLink
Log in

Combined ACL/PCL/Medial/Lateral Side Injuries of the Knee

  • Chapter
The Multiple Ligament Injured Knee

Abstract

The multiple ligament injured knee is a complex problem in orthopaedic surgery. Such injuries may or may not present as acute knee dislocations, and careful assessment of the extremity vascular status is essential because of the possibility of arterial and/or venous compromise. These complex injuries require a systematic approach to evaluation and treatment. Physical examination and imaging studies enable the surgeon to make a correct diagnosis and formulate a treatment plan.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Daniel DM, Akeson W, O’Conner J, eds. Knee Ligaments—Structure, Function, Injury, and Repair. New York: Raven Press; 1990.

    Google Scholar 

  2. Fanelli GC. PCL injuries in trauma patients. Arthroscopy 1993; 9 (3): 291–294.

    Article  PubMed  CAS  Google Scholar 

  3. Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients. Part II. Arthroscopy 1995; 11 (5): 526–529.

    Article  PubMed  CAS  Google Scholar 

  4. Fanelli GC, Giannotti BF, Edson CJ. Current concepts review. The posterior cruciate ligament arthroscopic evaluation and treatment. Arthroscopy 1994; 10 (6): 673–688.

    Article  PubMed  CAS  Google Scholar 

  5. Fanelli GC, Feldmann DD. Management of combined ACL/PCL/posterolateral complex injuries of the knee. Oper Techniques Sports Med 1999; 7 (3): 143–149.

    Article  Google Scholar 

  6. Fanelli GC, Feldmann DD. The dislocated/multiple ligament injured knee. Oper Techniques Orthop 1999; 9 (4): 298–308.

    Article  Google Scholar 

  7. Fanelli GC. Combined anterior and posterior cruciate ligament injuries: the multiple ligament injured knee. Sports Med Arthrosc Rev 1999; 7 (4): 289–295.

    Article  Google Scholar 

  8. Fanelli GC. Treatment of combined anterior cruciate ligament-posterior cruciate ligament-lateral side injuries of the knee. Clin Sports Med 2000; 19 (3): 493–502.

    Article  PubMed  CAS  Google Scholar 

  9. Fanelli GC, Edson CJ, Maish DR. Management of combined ACL/PCL injuries. Techniques Orthop 2001; 16 (2): 157–166.

    Article  Google Scholar 

  10. Fanelli GC. Surgical treatment of the acute and chronic ACL/PCL/medial side/lateral side injuries of the knee. Sports Med Arthrosc Rev 2001; 9(3).

    Google Scholar 

  11. Fanelli GC. Arthroscopic combined ACL/PCL reconstruction. In: Fanelli GC, ed. Posterior Cruciate Ligament Injuries. A Practical Guide to Management. New York: Springer-Verlag; 2001.

    Chapter  Google Scholar 

  12. Fanelli GC, Feldmann, Edson CJ, Maish DR. The multiple ligament injured knee. In: DeLee JC, Drez D, Miller M, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 2nd ed. In press.

    Google Scholar 

  13. Ghalambor N, Vangsness CT. Traumatic dislocation of the knee: a review of the literature. Bull Hosp Joint Dis 1995; 54 (1): 19–24.

    CAS  Google Scholar 

  14. Good L, Johnson RJ. The dislocated knee. J Am Assoc Orthop Surg 1995; 3 (5): 284–292.

    Google Scholar 

  15. Fanelli GC, Giannotti BF, Edson CJ. Arthroscopically assisted combined posterior cruciate ligament/posterior lateral complex reconstruction. Arthroscopy 1996; 12 (5): 521–530.

    Article  PubMed  CAS  Google Scholar 

  16. Shelbourne KD, Porter DA, Clingman JA, et al. Low velocity knee dislocation. Orthop Rev 1991; 20: 995–1004.

    PubMed  CAS  Google Scholar 

  17. Wascher DC, Dvirnak PC, DeCoster TA. Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma 1997; 11 (7): 525–529.

    Article  PubMed  CAS  Google Scholar 

  18. Shields L, Mital M, Cave EE Complete dislocation of the knee: experience at the Massachusetts General Hospital. J Trauma 1969; 9: 192–215.

    Article  PubMed  CAS  Google Scholar 

  19. Meyers MH, Harvey JP. Traumatic dislocation of the knee joint: a study of eighteen cases. J Bone Joint Surg Am 1971; 53: 16–29.

    PubMed  CAS  Google Scholar 

  20. Kennedy JC. Complete dislocation of the knee joint. J Bone Joint Surg Am 1963; 45: 889–904.

    PubMed  CAS  Google Scholar 

  21. Girgis FG, Marshall JL, Al Monajem ARS. The cruciate ligaments of the knee joint: anatomic, functional, and experimental analysis. Clin Orthop 1975; 106: 216–231.

    Article  PubMed  Google Scholar 

  22. Clancy WG. Repair and reconstruction of the posterior cruciate ligament. In: Chapman M, ed. Operative Orthopaedics. Philadelphia: JB Lippincott; 1988: 1651–1665.

    Google Scholar 

  23. Bleday RM, Fanelli GC, Giannotti BF, Edson CJ, Barrett TA. Instrumented measurement of the posterolateral corner. Arthroscopy 1998; 14 (5): 489–494.

    Article  PubMed  CAS  Google Scholar 

  24. Fowler PJ. Imaging of the posterior cruciate ligament. In: Fanelli GC, ed. Posterior Cruciate Ligament Injuries. A Practical Guide to Management. New York: Springer-Verlag; 2001, pp. 77–86.

    Google Scholar 

  25. Harner CD, Hoher J. Current concepts. Evaluation and treatment of posterior cruciate ligament injuries. Am J Sports Med 1998; 26 (3): 471–482.

    PubMed  CAS  Google Scholar 

  26. Skyhar MJ, Warren RF, Oritz GJ, et al. The effects of sectioning the posterior cruciate ligament and the posterolateral complex on the articular contact pressure within the knee. J Bone Joint Surg Am 1993; 75: 694–699.

    PubMed  CAS  Google Scholar 

  27. Fanelli GC, Giannotti BF, Edson CJ. Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction. Arthroscopy 1996; 12 (1): 5–14.

    Article  PubMed  CAS  Google Scholar 

  28. Fanelli GC, Edson CJ. Arthroscopically assisted combined ACL/PCL reconstruction. 2–10 year follow-up. Arthroscopy 2002; 18 (7): 703–714.

    Article  PubMed  Google Scholar 

  29. Fanelli GC, Feldman DM. The use of allograft tissue in knee ligament reconstruction. In: Parisien JS, ed. Current Techniques in Arthroscopy. Philadelphia: Current Medicine; 1998, pp. 47–55.

    Google Scholar 

  30. Malek MM, Fanelli GC, DeLuca JV. Intraarticular and extraarticular anterior cruciate ligament reconstruction. In: Scott WN, ed. The Knee. St Louis, MO: CV Mosby; 1994: 791–812.

    Google Scholar 

  31. Malek MM, Fanelli GC, Golden MD. Combined intraarticular and extraarticular anterior cruciate ligament reconstruction. In: Scott WN, ed. Ligament and Extensor Mechanism Injuries of the Knee. St Louis, MO: CV Mosby; 1991: 267–284.

    Google Scholar 

  32. Fanelli GC, Desai BM, Cummings PD, Hanks GA, Kalenak A. Divergent alignment of the femoral interference screw in single incision endoscopic reconstruction of the anterior cruciate ligament. Contemp Orthop 1994; 28 (1): 21–25.

    Google Scholar 

  33. Fanelli GC, Larson RV. Practical management of posterolateral instability of the knee. Arthroscopy 2002; 18 (2, suppl 1): 1–8.

    PubMed  Google Scholar 

  34. Wascher DC, Grauer JD, Markoff KL. Biceps tendon tenodesis for posterolateral instability of the knee. An in vitro study. Am J Sports Med 1993; 21 (3): 400–406.

    Article  PubMed  CAS  Google Scholar 

  35. Muller W. The Knee: Form, Function, and Ligamentous Reconstruction. New York: Springer-Verlag; 1983.

    Google Scholar 

  36. Ibrahim SA. Primary repair of the cruciate and collateral ligaments after traumatic dislocation of the knee. J Bone Joint Surg Br 1999; 81 (6): 987–990.

    Article  PubMed  CAS  Google Scholar 

  37. Martinek V, Imhoff AB. Combined anterior cruciate ligament and posterior cruciate ligament injury-technique and results of simultaneous arthroscopic reconstruction. Zentralbi Chir 1998; 123 (9): 1027–1032.

    CAS  Google Scholar 

  38. Noyes FR, Barber-Westin SD. Reconstruction of the anterior and posterior cruciate ligaments after knee dislocation. Use of early protected motion to decrease arthrofibrosis. Am J Sports Med 1997; 25 (6): 769–778.

    Article  PubMed  CAS  Google Scholar 

  39. Wascher DC, Becker JR, Dexter JG, Blevins FT. Reconstruction of the anterior and posterior cruciate ligaments after knee dislocation. Results using fresh frozen nonirradiated allografts. Am J Sports Med 1999; 27 (2): 189–196.

    PubMed  CAS  Google Scholar 

  40. Yeh WL, Tu YK, Su JY, Hsu RW. Knee dislocation: treatment of high velocity knee dislocation. J Trauma Inj Infect Crit Care 1999; 46 (4): 693–701.

    Article  CAS  Google Scholar 

  41. Tegner Y, Lysholm J. Rating system in the evaluation of knee ligament injuries. Clin Orthop 1985; 198: 43–49.

    PubMed  Google Scholar 

  42. Windsor RE, Insall JN, Warren RF, Wickiewicz TL. The Hospital for Special Surgery knee ligament rating form. Am J Knee Surg 1988; 1: 140–145.

    Google Scholar 

  43. Torg JS, Conrad W, Kalen V. Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med 1976; 4: 84.

    Article  PubMed  CAS  Google Scholar 

  44. Galway HR, MacIntosh DL. The lateral pivot shift: a symptom and sign of anterior cruciate ligament insufficiency. Clin Orthop 1980; 147: 45–50.

    PubMed  Google Scholar 

  45. Veltri DM, Warren RE AAOS Instructional Course Lecture. Posterolateral instability of the knee. J Bone Joint Surg Am 76; 3: 460–472.

    Google Scholar 

  46. Jakob RP, Hassler H, Staubli HU. Experimental studies on the functional anatomy and the pathomechanism of the true and reversed pivot shift sign. Acta Orthop Scand 1981; 5 (suppl): 18–32.

    Google Scholar 

  47. Fanelli GC, Monahan TJ. Complications and pitfalls in posterior cruciate ligament reconstruction. In: Malek MM, Fanelli GC, Johnson Darren, Johnson Don, section eds. Knee Surgery: Complications, Pitfalls, and Salvage. New York: Springer-Verlag; 2001, pp. 121–128.

    Google Scholar 

  48. Fanelli GC, Monahan TJ. Complications of posterior cruciate ligament reconstruction. Sports Med Arthrosc Rev 1999; 7 (4): 296–302.

    Article  Google Scholar 

  49. Fanelli GC, Monahan TJ. Complications in posterior cruciate ligament and posterolateral complex surgery. Oper Techniques Sports Med 2001; 9 (2): 96–99.

    Article  Google Scholar 

  50. Fanelli GC. Complications in PCL surgery. In: Fanelli GC, ed. Posterior Cruciate Ligament Injuries. A Practical Guide to Management. New York: Springer-Verlag; 2001, pp. 291–302.

    Chapter  Google Scholar 

  51. Fanelli GC. Complications in the multiple ligament injured knee. In: Schenck RC Jr, ed. Monograph on Multiple Ligamentous Injuries of the Knee in the Athlete. Rosemont, IL: American Association of Orthopaedic Surgeons; 2002: 101–107.

    Google Scholar 

Download references

Authors
  1. Gregory C. Fanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Arthroscopic Surgery and Sports Medicine, Fanelli Sports Injury Clinic, Department of Orthopaedic Surgery, Geisinger Clinic Medical Center, 17822, Danville, Pennsylvania, USA

    Gregory C. Fanelli MD (Chief) (Chief)

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer Science+Business Media New York

About this chapter

Cite this chapter

Fanelli, G.C. (2004). Combined ACL/PCL/Medial/Lateral Side Injuries of the Knee. In: Fanelli, G.C. (eds) The Multiple Ligament Injured Knee. Springer, New York, NY. https://doi.org/10.1007/978-0-387-22522-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-22522-7_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-2342-4

  • Online ISBN: 978-0-387-22522-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation