A Systematic Review of all Published Systematic Reviews (SRs) on Multiligament Knee Injuries (MLKIs)

Multiligament knee injuries are an uncommon and heterogeneous group of injuries and standardizing reporting on these injuries is a challenge. Given the complexity of multiligament knee injuries (MLKIs) and the ongoing debate regarding optimal management strategies, a comprehensive understanding of the current evidence is essential to guide evidence-based decision-making and improve patient care.

In this systematic review, we aimed to assess the systematic reviews and meta-analyses on MLKIs and synthesize their findings. This will enable us to identify areas where the current evidence is strong and where further research is needed.

Adhering to PRISMA guidelines, a comprehensive search in PubMed, Embase, and Cochrane Library identified 36 eligible systematic reviews. AMSTAR 2 criteria were used to assess the methodological quality. For agreement between the raters, the inter-rater reliability Cohen's kappa was used.

Most of the systematic reviews assessed with AMSTAR 2 criteria had a critically low level of evidence (n = 26), with the rest being low (n = 8), moderate (n = 3), and one high, indicating caution in interpreting findings.

This study highlights the scarcity of high-quality systematic reviews (SRs) on multiligament knee injuries (MLKIs), largely due to the diversity in injury patterns, management protocols, and reporting standards.

Most research on these injuries are of low quality, and recommendations have been made to improve reporting. Many areas of these injuries require further studies to improve the outcomes.