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Combined reconstruction of medial collateral ligament and posterior cruciate ligament using one femoral tunnel: a technical note and case report applicable to limited-resource settings
  1. Túlio Campos1,
  2. Marcelo Perucci1,
  3. Paulo Gomes1 and
  4. Vincenzo Giordano2
  1. 1Orthopaedic Surgery, Universidade Federal de Minas Gerais Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
  2. 2Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, Brazil
  1. Correspondence to Dr Vincenzo Giordano; v_giordano{at}


Knee dislocations are severe injuries difficult to treat. Specially in low-resources scenarios, reconstruction of multiple ligaments can be challenging. We describe a technical note that can be reconstruct multi ligaments using ipsilateral hamstrings autograft. A posteromedial knee incision is made to visualise the medial corner of the knee and to reconstruct medial collateral ligament (MCL) and posterior cruciate ligament (PCL) with semitendinosus and gracilis tendon graft, using one femoral tunnel from the anatomic femoral insertion of the MCL to the anatomic femoral insertion of the PCL. After 1-year follow-up, the patient returned to his previous function with a Lysholm score of 86. This technique can reconstruct more than one ligament anatomically with limited graft resource.

  • Knee injuries
  • Ligament rupture
  • Physiotherapy (sports medicine)
  • Orthopaedic and trauma surgery

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  • Contributors All Authors made substantial contributions to the design and implementation of the study, to the analysis of the results and to the writing of the manuscript. Conceptualisation, TC and MP; methodology, TC, MP, PG and VG; validation, TC, MP, PG and VG; formal analysis, TC and VG; investigation, TC, MP and PG; resources, TC, MP, PG and VG; data curation, TC, MP and PG; writing—original draft preparation, TC; writing—review and editing, VG, MP, PG and TC; visualisation, VG, MP and TC; supervision, TC, MP, PG and VG; project administration, TC and MP; funding acquisition, TC. All authors have read and agreed to the published version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.