Vascular Injuries in Multiligament Knee Injuries (MLKIs)

Area of Science:

• Orthopaedic Surgery
• Vascular Surgery
• Trauma Management

Background:

• Vascular injuries are uncommon but serious complications of severe knee injuries, including multiligament knee injuries (MLKIs).
• Prompt diagnosis and management are essential to prevent limb loss, with high-energy trauma being a common cause, but low-energy trauma in obese individuals also poses a risk.
• Advancements in detection and treatment have significantly reduced amputation rates associated with these injuries.

Purpose of the Study:

• To provide a comprehensive review of vascular injuries associated with MLKIs.
• To highlight the importance of early detection and management of vascular issues in MLKIs.
• To discuss current diagnostic and treatment strategies, emphasizing the need for improved techniques to avoid amputations.

Main Methods:

• This article presents a conceptual review of vascular injuries in MLKIs.
• It synthesizes recent literature, expert opinions, and clinical experience.
• The review includes an evaluation by specialists with over a decade of expertise in surgical techniques.

Main Results:

• MLKIs with vascular damage require meticulous assessment and advanced treatments to minimize amputation risk.
• Timely identification and intervention for vascular lesions, particularly in the popliteal artery, are key to reducing amputations.
• Emerging evidence indicates an increased risk in low-energy scenarios, especially in obese patients.

Conclusions:

• Effective management of vascular complications in MLKIs is vital for limb salvage.
• Utilizing physical examinations and advanced imaging like CT angiography (CTA) or MR angiography (MRA) is crucial for diagnosis and treatment planning.
• MRA is particularly valuable for identifying both vascular and structural knee damage, guiding surgical decisions.