Management of multiligament knee injuries

Area of Science:

• Orthopedic Surgery
• Traumatology
• Vascular Surgery

Background:

• Multiligament knee injuries (MLKI) can involve significant vascular compromise, affecting up to 18% of cases.
• Associated common peroneal nerve injuries present varying recovery potentials, with partial injuries faring better than complete palsies.

Purpose of the Study:

• To outline diagnostic and management strategies for multiligament knee injuries.
• To emphasize the importance of vascular assessment and timely surgical intervention.
• To review optimal surgical techniques and rehabilitation protocols for MLKI.

Main Methods:

• Assessment of MLKI involves ankle brachial pressure index (ABPI) screening, with arteriography indicated for ABPI < 0.9.
• Immediate surgical stabilization and re-vascularization are critical for ischemic limbs.
• Surgical options include acute or staged reconstructions, with specific considerations for ligamentous and nerve injuries.

Main Results:

• Operative treatment, including reconstruction, offers the best outcomes for MLKI.
• Posterolateral corner reconstruction demonstrates a lower failure rate compared to repair.
• Early mobilization post-surgery minimizes range-of-motion deficits.

Conclusions:

• Prompt vascular assessment and intervention are crucial in MLKI management.
• Surgical reconstruction generally yields superior results over primary repair for certain structures.
• A structured approach involving timely surgery and early rehabilitation optimizes patient recovery from MLKI.