Ligament reconstruction combined with osteotomy: Case report

韧带重建联合截骨术:病例报告

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Abstract

RATIONALE: Valgus deformity of the knee joint is caused by congenital anatomical abnormalities. The occurrence of an anterior cruciate ligament (ACL) tear in conjunction with a medial patellofemoral ligament (MPFL), alongside knee valgus deformity, is exceedingly rare in clinical practice. PATIENT CONCERNS: A 30-year-old female presented with congenital valgus knee. The left knee joint was immobile due to pain and swelling after trauma. The patient had a history of hypertension. DIAGNOSES: The patient underwent an MRI of the left knee joint at a local hospital, and was diagnosed with ACL injury of the left knee, medial patellofemoral ligament (MPFL) injury of the patella, and congenital valva deformity. INTERVENTIONS: The patient underwent simultaneous reconstruction of the ACL and MPFL, as well as a distal femoral osteotomy. OUTCOMES: The patient experienced significant postoperative improvement, with marked pain relief. The knee remained stable, and functional recovery was observed. LESSONS: Failure to adequately address the stability of the patella following the rupture of the MPFL may result in increased stress on the ACL graft, thereby heightening the risk of graft failure. Additionally, valgus deformity can impose abnormal mechanical loads on the ACL graft, substantially elevating the likelihood of complications such as articular cartilage degeneration and meniscal injury. Usually, we need accurate guidance on imaging and evaluation of surgical options to successfully complete the surgery.

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