Surgical management of the multiple-ligament injured knee: a case series from Chongqing, China and review of published reports

Orthop Surg. 2013 Nov;5(4):239-49. doi: 10.1111/os.12077.

Abstract

Objective: The correct management of multiple-ligament injured knees (MLIKs) remains controversial. This study aimed to summarize the epidemiological features and short-term results of patients treated in our department.

Methods: Sixty-six patients diagnosed with MLIKs from 2009 to 2011 were enrolled. Relevant patient characteristics and clinical variables were analyzed to characterize the epidemiology. A surgical algorithm based on a knee dislocation classification system and postoperative rating scales, including Lysholm and Tegner rating, as well as joint mobility, stability and radiography were collected for functional evaluation at 2.5-year follow-up.

Results: The epidemiological profile demonstrated that 30- to 50-year-old men were at the highest risk. The primary causes were vehicle accidents and falls and most common injury type cruciate combined collateral ligament injuries. Final follow-up analysis comparing operative versus conservative management and surgically treated mild versus severe MLIKs showed significant differences in Lysholm and Tegner scale scores, as well as knee mobility and stability.

Conclusion: The therapeutic outcome of MLIKs depends on various clinical variables and a surgical algorithm. Satisfactory restoration of function was acquired in the majority of our surgically treated MLIK cases; however, most patients had not achieved their pre-injury activity levels by the follow-up endpoint.

Keywords: Follow-up; Knee; Ligament injury; Reconstruction.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / etiology
  • Knee Injuries / diagnosis
  • Knee Injuries / diagnostic imaging
  • Knee Injuries / rehabilitation
  • Knee Injuries / surgery*
  • Knee Joint / diagnostic imaging
  • Knee Joint / pathology
  • Knee Joint / physiopathology
  • Ligaments, Articular / injuries*
  • Ligaments, Articular / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Trauma / diagnosis
  • Multiple Trauma / rehabilitation
  • Multiple Trauma / surgery*
  • Postoperative Complications
  • Radiography
  • Range of Motion, Articular
  • Recovery of Function
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult