Outcomes Following Multiligament Knee Injuries: A Systematic Review of Studies With a Minimum 7-Year Follow-up.

Area of Science:

• Orthopedics
• Sports Medicine
• Reconstructive Surgery

Background:

• Multiligament knee injuries (MLKIs) present complex challenges for achieving optimal long-term patient outcomes.
• Systematic review focusing on clinical and functional results, complications, and return-to-sport rates after MLKIs.

Purpose of the Study:

• To evaluate long-term clinical and functional outcomes following multiligament knee injuries (MLKIs) with a minimum 7-year postoperative follow-up.

Main Methods:

• Systematic review of 16 studies (730 knees) following PRISMA guidelines.
• Qualitative analysis due to study heterogeneity, extracting data on patient-reported outcomes, return-to-sport, osteoarthritis, complications, and reoperations.

Main Results:

• Patient-reported outcomes were variable and generally modest long-term.
• Return-to-sport rates ranged from 60.4% to 85%.
• Osteoarthritis progression (Kellgren-Lawrence grades 3-4) occurred in 12%-71.7% of patients.
• Reoperation rates varied (1.7%-34.3%), often for stiffness; total knee arthroplasty conversion ranged from 0%-10.9%.

Conclusions:

• Outcomes >7 years show functional restoration and sport participation but are impacted by significant osteoarthritis and reoperation rates for stiffness.
• Surgical technique and early rehabilitation advances are improving outcomes in recent studies.
• Prospective evaluation with standardized protocols is crucial for joint preservation and quality of life.