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Related Experiment Video

Updated: Feb 16, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
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Revision Multiligament Knee Reconstruction: Clinical Outcomes and Proposed Treatment Algorithm.

Jarret M Woodmass1, Michael P O'Malley1, Aaron J Krych1

  • 1Department of Orthopedic Surgery & Sports Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|December 24, 2017
PubMed
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Revision multiligament knee injury (MLKI) reconstruction shows modest functional outcomes. A standardized algorithm focusing on concomitant pathologies, often in a staged manner, improves results for patients with recurrent instability after MLKI.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Knee Reconstruction

Background:

  • Multiligament knee injuries (MLKI) often require complex surgical management.
  • Revision surgery for MLKI presents unique challenges due to prior interventions and potential complications.
  • Recurrent instability after initial MLKI reconstruction necessitates further evaluation and treatment strategies.

Purpose of the Study:

  • To evaluate the clinical outcomes of revision multiligament knee injury (MLKI) reconstruction.
  • To assess outcomes at a minimum of two years post-revision surgery.
  • To present a standardized treatment algorithm for managing revision MLKI.

Main Methods:

  • Retrospective review of a specialized MLKI database.
  • Inclusion of patients undergoing revision MLKI reconstruction (≥2 ligaments) after 2000 with ≥2 years follow-up.

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  • Data collection included demographics, injury details, surgical techniques, failure mechanisms, stability, range of motion, IKDC, and Lysholm scores.

    • Main Results:

    • Twenty-three patients (8 female, 15 male) with an average age of 30.8 years at revision surgery were analyzed.
    • Mean follow-up was 7.5 years; 43.4% underwent staged revision procedures.
    • Average IKDC and Lysholm scores were 74.5 and 79.4, respectively. High-energy injury and older age at revision were linked to worse outcomes.

    Conclusions:

    • Revision MLKI reconstruction can yield modest functional improvements.
    • Concomitant pathologies like malalignment, bone tunnel issues, and cartilage defects are common.
    • A standardized treatment algorithm, addressing these pathologies often in a staged approach, is crucial for successful revision MLKI surgery.