Poly-traumatic multi-ligament knee injuries: is the knee the limiting factor?

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Sports Medicine

Background:

• Multi-ligament knee injuries (MLKI) are severe, often resulting from high-velocity trauma.
• These injuries are rare in isolation and can be a component of polytrauma, significantly impacting patient prognosis.
• Understanding functional outcomes in polytrauma patients with MLKI is crucial for effective treatment strategies.

Purpose of the Study:

• To compare functional outcomes of knee reconstruction in patients with MLKI due to polytrauma versus those with isolated MLKI.
• To identify potential risk factors for poorer outcomes in the polytrauma cohort.

Main Methods:

• A matched cohort analysis included 62 patients with MLKI, comparing polytrauma cases to isolated injuries.
• Patients were matched for age, sex, and knee dislocation grade.
• Functional outcomes (IKDC, Lysholm scores) and physical examinations were assessed at a minimum 2-year follow-up.

Main Results:

• The polytrauma cohort showed significantly lower mean IKDC (57.2) and Lysholm (62) scores compared to the isolated injury group (IKDC 71.1, Lysholm 78).
• No significant differences were observed in physical examination findings between the groups.
• No identified risk factors predicted poorer outcomes within the polytrauma group.

Conclusions:

• Polytrauma patients with MLKI exhibit diminished functional recovery post-reconstruction, despite achieving similar knee stability and range of motion.
• Factors beyond the knee injury itself, such as concomitant injuries and psychosocial elements, likely influence functional outcomes.
• This highlights the complex nature of treating MLKI in the context of polytrauma.