Multiligamentous knee injury – A Level III study to describe systematic approach, management and rehabilitation protocol with review of literature

Abstract

IntroductionMultiligamentous knee injury (MLKI) is a complex and difficult entity in terms of management and rehabilitation programme due to lack of consensus in literature over optimal treatment guidelines. Thus this case series was intended to describe our surgical technique, sequence of fixation of ligaments with functional & clinical outcomes following reconstruction of ligaments and rehabilitation protocol. Material and methods20 consecutive patients diagnosed with MLKI between 2015 and 2017 were enrolled and underwent surgical reconstruction/repair of torn ligaments. A prospective collected data of all patients were analysed retrospectively in terms of clinical and functional outcome by assessing the patients with their range of motion (ROM), lysholm and tegner activity scores. ResultsA total of 20 MLKI patients who were operated from 2015 to 2017 were recruited and followed up for a mean period of 1.8 years (range 6 months to 2 years). Mean range of motion among the KD groups (I-V) was from 5° to 111.67°. Mean Lysholm score among the KD groups (I-V) was 84.53. Mean Tegner activity level of KD groups (I-V) before injury was 4.6 and mean current level at the time of follow up was 3.6. No significant medial laxity was observed at final follow up period. ConclusionWe found good functional outcome in most cases treated by our systematic approach and management protocol. Better functional outcomes in MLKIs needs thorough clinico-radiological evaluation and proper surgical planning in terms of repair/reconstruction. Early intervention (<3 weeks), multistage reconstruction and individualized rehabilitation are key factors for early return to activities.