The knee joint is the most power bearing joint and hence is prone to Injuries. Combined ACL-PCL injuries are uncommon injuries that occur due to knee dislocation caused by the high velocity of trauma. Dislocation of the knee itself is a relatively rare injury constituting 0.02% – 0.2% of orthopedic injuries. Associated neuro-vascular damage, as well as fractures, makes these types of injuries more challenging to treat. It becomes extremely important to evaluate and correctly identify the structures involved in the injury early and to treat them aggressively, including rehabilitation so that the person returns to his work and sport with the most stable and healthy knee as possible.

When patients presenting with bi-cruciate ligament deficiency with or without posterolateral corner (PLC) injury require reconstruction in the knee, a single setting or staged approach can be adopted. Although some authors still recommend staged reconstruction, beginning with the posterior cruciate ligament (PCL), and later the anterior cruciate ligament (ACL) if necessary. Early simultaneous reconstruction of the ACL and PCL and repair or reconstruction of the medial and lateral structures are recommended. Also, staged procedures are much more time consuming for the patient, and it requires two operative procedures as well as two rehabilitation programs.

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