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Surgical treatment of multiligament knee injuries

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To analyse one institution’s experience with multiligament knee injuries.

Methods

Over 10 years, 133 multiligament knee injuries including 130 patients were included in the study. Inclusion criteria included: (1) injury to two or more knee ligaments (2) multiligament knee repair/reconstructive surgery.

Results

The average age at time of injury was 26 years old, and 76 % were male. Fifty-one (38 %) multiligament knee injuries had >2 ligaments injured. Peroneal injuries occurred in 26 patients (20 %), and four (3 %) had associated vascular injuries. A high energy mechanism of injury was noted in 39 %. Twenty-five per cent of patients had an additional orthopaedic injury and, 11.5 % suffered additional non-orthopaedic injuries. Definitive surgical intervention was performed acutely (<3 weeks) in 47 %. Ninety-one per cent of multiligament knee injuries underwent reconstruction with or without repair. Forty-three complications occurred in 37 patients. Patients who suffered >2 ligament injury or had surgery acutely were at an increased risk of knee stiffness requiring manipulation under anaesthesia (MUA) (p = 0.016 and p = 0.047, respectively). Knees with >2 ligaments injured were associated with higher post-operative complications (p = 0.007). Knee dislocation IV knees were at increased risk to undergo revision surgery (p = 0.041). Obese patients were more likely to have a post-operative infection (p = 0.038). Repair, reconstruction or type of graft used had no impact on need for revision surgery.

Conclusions

Multiligament knee injured patients undergoing surgical intervention are a highly complex patient population. This study outlines the patient population, treatment, and complications of one academic institution over 10 years. Overall complications were higher in patients with >2 ligaments injured. Knee stiffness requiring MUA was more common in patients who had >2 ligaments ruptured and those treated acutely. Knees with all four ligaments injured were more likely to undergo revision surgery.

Level of evidence

Retrospective case series, Level IV.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA, 52242, USA

    Shane Cook, T. J. Ridley, Mark A. McCarthy, Yubo Gao, Brian R. Wolf, Annunziato Amendola & Matthew J. Bollier

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  1. Shane Cook
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  2. T. J. Ridley
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  3. Mark A. McCarthy
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  4. Yubo Gao
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  6. Annunziato Amendola
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Correspondence to Shane Cook.

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Cook, S., Ridley, T.J., McCarthy, M.A. et al. Surgical treatment of multiligament knee injuries. Knee Surg Sports Traumatol Arthrosc 23, 2983–2991 (2015). https://doi.org/10.1007/s00167-014-3451-1

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  • DOI: https://doi.org/10.1007/s00167-014-3451-1

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