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Updated: Jan 18, 2026
Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Evaluating Surgical Strategies and Functional Outcomes in Multi-Ligamentous Knee Injuries: A Prospective Study in
Vatsal Mehta1, Aditya Agrawal2, Abhishek Vaish3
1Department of Orthopedics, Pukhraj Raichand General Hospital, Ahmedabad, Gujarat, India.
Background And Aims:
Multiligamentous knee injuries (MLKIs) are uncommon yet complex, presenting challenges in diagnosis, treatment, and rehabilitation. This study aims to evaluate the incidence, causes, surgical techniques, and functional outcomes of MLKI cases in Indian patients.
Materials And Methods:
A prospective study was conducted at a tertiary care center. Patients underwent surgical intervention based on clinical evaluation, employing both single-stage and staged reconstruction strategies. The sequence of ligament repair and graft selection was tailored to each case. Post-operative outcomes were assessed using the knee society score (KSS) and Lysholm score.
Results:
70 MLKI cases were treated between January 2021 and July 2023, with two patients lost to follow-up, all patients had anterior cruciate ligament injuries, with additional ligament involvement observed in posterior cruciate ligament (24%), medial collateral ligament (32%), and posterolateral corner (27%). Meniscal injuries were noted in 40% of cases. Graft selection included semitendinosus and gracilis tendons (54%) and peroneus longus (46%), with an average graft diameter of 8 ± 1 mm. No significant differences in outcomes were found between graft types (P > 0.05). At 6 months post-surgery, the mean KSS improved from 51 ± 10 to 80 ± 5, while Lysholm scores increased from 60 ± 10 to over 80. Notably, 90% of patients achieved excellent results.
Conclusion:
Early, well-planned single-stage reconstruction emerges as an effective strategy for managing MLKIs, yielding favorable functional outcomes. Tailoring surgical approaches based on individual injury profiles significantly optimizes recovery.
