Abstract
The assessment of a patient with a multiple-ligament-injured knee requires a careful history and clinical evaluation. Missed concomitant ligament disruptions in the setting of an anterior cruciate ligament (ACL) tear can increase the failure rate of the ACL graft. Additionally, unrecognized and/or untreated posterolateral corner (PLC) or medial-sided knee injuries can lead to chronic disability. A thorough history and physical examination, combined with proper imaging studies, can facilitate an accurate diagnosis. These complex injuries require a systematic approach for treatment. Acute grade one or two medial collateral ligament (MCL) tears in the setting of an ACL tear can often be treated with bracing of the MCL, depending on the location, followed by ACL reconstruction. Combined ACL and PLC injuries are best treated acutely with ACL reconstruction and primary repair of the posterolateral knee injuries. However, the vascular status, soft tissue swelling, and medical comorbidities must be taken into account when determining the optimal time for surgical intervention. Chronic ACL and PLC tears are best treated with anatomic ACL and PLC reconstructions.
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