Management of Neglected Multiple Ligament Rupture of the Knee: A Case Report

Maodah Fa,Rhatomy S

doi:10.5704/moj.2111.018

Abstract

Delayed or neglected multiple ligament injury of the knee is challenging or doctors and physiotherapists. We report on a 36-year-old army man who presented to the outpatient orthopaedic department with complaints of pain and deformity of his right knee and an inability to weight-bear on the right leg. The examination of the right knee revealed an unreduced posterior dislocation of the knee with instability in all planes and a limited range of motion (ROM) from 10° to 100°. Quadriceps wasting was noted. Roentgenograms revealed a posterior dislocation of the knee. Magnetic resonance imaging (MRI) showed complete rupture of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and the patellar tendon. A two-stage surgery was planned, involving soft tissue distraction with external fixation to restore the knee joint, followed by multiple ligament reconstruction. Three months after surgery, the patient could walk normally with ROM between 0° to 120°.

Highlights

Knee dislocation after high energy trauma poses a major challenge to patients and treating physicians
The definition of a multi-ligament knee injury is commonly recognised as a tear of at least two of the four major knee ligament structures: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the posteromedial corner (PMC) and the posterolateral corner (PLC)[1]
We report the management of a neglected multiple ligament rupture of the knee

Summary

Introduction

Knee dislocation after high energy trauma poses a major challenge to patients and treating physicians. Delayed surgery allowed for restoration of preoperative knee range of motion, recovery of soft tissues with a resolution of swelling, and possibly less stiffness and wound complications post-operatively[1,2,3]. There are only a few studies that reported on the management of these delayed or neglected multiple ligament rupture of the knee.

Results

Conclusion