“Short term functional outcomes of single Stage Surgically treated Multiligamentous Knee injuries in cases of Knee Dislocation”

Abstract

Introduction: Knee dislocation is a disastrous injury with significant displacement of tibia over femur leading to
disruption of multiple ligaments of knee and other surrounding soft tissue structures. Open wounds and
neurovascular insult can put the limb in jeopardy. The complexity of injury and varied treatment makes this MLKI
challenging.
Purpose : This review article describes multiligament knee injuries (MLKI) in depth, with a focus on associated
injuries, operative management, outcomes, and complications.
Materials and Methods : We conducted a retrospective observational study of all patients who underwent MLKI
surgeries between 2014 to 2020 in a dedicated Arthoscopy and sports injury Center (Deliwala Hospital in
Bhavnagar). Over the past 7 years, we have treated many cases and have taken 30 cases for this article. The
Schenck knee dislocation classification was used to classify the ligament injury patterns.
Results : The male of age group 36-50 yrs most commonly involved. High Velocity flexion injury is most common
mechanism. Medial sided bicruciate injuries most common pattern. 3 patients develops knee stiffness, 2 superficial
wound infection and 1 had popliteal artery injury. Early surgeries (3-6 weeks) is always preferred over delayed
one.Repair had higher failure rate and lower return to sports activities compared to reconstructions. Surgical
treatment has higher mean Lysholm score96.3.
Conclusions : This review suggests that the best treatment guidelines for MLKI is still awaited due to
heterogeneous nature of the injuries themselves and the many treatment strategies available, but better functional
outcomes havebeen achieved with reconstruction rather than repair. Surgery must be performed early within 6
weeks for better results.When feasibleACL reconstruction can be delayed thereby reducing rate of
arthrofibrosis.High-quality research efforts needed to investigate best modality of treatment of MLKI.