Purpose: To describe our institutional experience and results in the surgical management of multiligament knee injuries (MLKI).
Materials And Methods: Retrospective series of MLKI consecutively operated on at a single, level I Trauma Center. Data on patients' baseline characteristics, injuries, treatments, and outcomes were recorded up to one-year follow-up. Recorded outcomes included the Tegner-Lysholm Knee Scoring Scale (TLKSS), return to work, and patient satisfaction.
Results: MLKI incidence was 0.03% among 9897 orthopedic trauma admissions. Twenty-four patients of mean age 43.6 years were included in analysis. The mean Injury Severity Score was 12.6. Five patients presented with knee dislocations and six had fracture-dislocations, two of them open fractures. There was one popliteal artery injury requiring a bypass and four common peroneal nerve palsies. Staged ligamental reconstruction was performed in all cases. There were seven postoperative complications. The median TLKSS was 80 and, though patient satisfaction was high, and dissatisfaction was largely restricted to recreational activities (only 58.3% satisfied). Seventeen patients returned to their previous employment.
Conclusions: We found a high aggregation of fracture-dislocations secondary to road traffic accidents. One in four patients experienced complications, particularly stiffness. Complications were more common in cases involving knee dislocation. Most patients had good functional results, but 25% were unable to return to their previous work, which demonstrates the long-lasting sequelae of this injury.
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http://dx.doi.org/10.1007/s00590-023-03807-4 | DOI Listing |
Arch Orthop Trauma Surg
January 2025
Medical University of Graz, Graz, Austria.
Background: The role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Orthopaedic Division, Oslo University Hospital, Oslo, Norway.
Background: Multiligament knee injuries (MLKIs) are heterogeneous, and bicruciate knee ligament injuries are considered a serious form of this injury. The current literature tends not to distinguish between single and bicruciate MLKI when reporting outcomes.
Purpose: To investigate patient-reported outcomes after surgical treatment of MLKI comparing single cruciate MLKI with bicruciate MLKI.
Rev Bras Ortop (Sao Paulo)
December 2024
Serviço de Ortopedia, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.
The original LaPrade technique for anatomic reconstruction of the posterolateral corner of the knee uses two separate allografts. More recently, a modification of this technique, using an adjustable-length suspension device with a cortical button for tibial fixation, allows anatomic reconstruction with a single semitendinosus autograft. This modification is of utmost relevance when sources of allograft are not available for multiligament knee reconstruction.
View Article and Find Full Text PDFJ Orthop Traumatol
December 2024
Clinica Ortopedica E Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli, 1, 40136, Bologna, Italy.
J Exp Orthop
October 2024
Bone, Joint and Related Tissue Research Center Shahid Beheshti University of Medical Sciences Tehran Iran.
Purpose: Multiligament knee injuries (MLKIs) involve various ligaments in the knee. Current double-bundle anatomical reconstructions of the medial collateral ligament (MCL) increase the level of technical complexity, often resulting in the establishment of numerous bone tunnels and different fixation points with additional hardware. To overcome these limitations, we proposed a novel minimally invasive nonanatomical MCL reconstruction with one tibial tunnel in the metaphysis using Achilles allograft in the MLKI setting.
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