Recovery Stages After Multiligament Knee Reconstruction

Multiligament knee injuries are severe limb-threatening injuries involving a tear of two or more of the major knee ligaments including the anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, and fibular (lateral) collateral ligament/posterolateral corner. Anatomic reconstructions can help restore joint stability, which is complemented by a postoperative rehabilitation program to maximize knee function. The postoperative recovery will likely be extended compared with single-ligament procedures and usually involves robust precautions. However, it can be started the day after the reconstruction procedure to include initiation of knee motion. The goals are similar to those of single-ligament procedures including gradual recovery of motion, strength, and load capacity; as well as symptom control, restoration of cardiovascular fitness, and long-term joint protection. These are achieved through a protocolized rehabilitation program that involves four phases: recovery phase, transition phase, rebuild phase, and restore phase. Their goals and milestones are incremental to achieve optimal patient outcomes. With a team-based approach to protocolized recovery between the patient, surgeon, and rehabilitation team, patient function and return to activities can be maximized.