Knee Multiligament Reconstruction: ACL / PCL / MCL.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Knee reconstruction

Background:

• Multiligament knee injury (MLKI) is a rare and complex condition requiring surgical intervention.
• Optimal timing, surgical staging, and graft selection for MLKI reconstruction lack established consensus.
• Delayed, single-stage reconstruction may offer benefits, including improved preoperative range of motion and potential healing of extra-articular structures.

Purpose of the Study:

• To evaluate the effectiveness of single-stage reconstruction for multiligament knee injuries (MLKI).
• To review surgical techniques and outcomes reported in the literature for MLKI.
• To highlight the need for further research into optimal surgical timing and graft choices.

Main Methods:

• Review of literature reporting on single-stage reconstruction for MLKI.
• Description of a surgical technique involving arthroscopy, hamstring autograft, and Achilles allograft for ACL and PCL reconstruction.
• Inclusion of medial collateral ligament reconstruction using a semitendinosis allograft.
• Use of fluoroscopy to confirm tunnel placement and screw trajectory.

Main Results:

• Studies reported favorable outcomes with single-stage reconstruction, including high Lysholm and IKDC scores.
• Patients undergoing single-stage reconstruction demonstrated good postoperative range of motion and return to sport.
• Literature supports the efficacy of single-stage reconstruction for MLKI, with minimal residual laxity reported in some series.

Conclusions:

• Single-stage reconstruction is an effective intervention for multiligament knee injuries (MLKI).
• Existing literature supports the use of single-stage reconstruction, with various graft options showing positive results.
• Further research is essential to establish optimal surgical timing and graft selection for MLKI.