Multiple ligament knee injury: complications

Abstract

Non-operative and operative complications are common following multiple ligament knee injuries. This article will describe common complications seen by the surgeon and physical therapist following this complex injury. Complications include fractures, infections, vascular and neurologic complications following injury and surgery, compartment syndrome, complex regional pain syndrome, deep venous thrombosis, loss of motion and persistent laxity issues. A brief description of these complications and methods for evaluation and treatment will be described.

Figure 1.

Arteriogram demonstrating complete disruption of the popliteal artery at the knee joint, with minimal distal perfusion. (Reprinted with permission from Wascher DC: High-velocity knee dislocation with vascular injury: Treatment principles. Clin Sports Med. 19:470, 2000)

Figure 2.

Arteriogram demonstrating intimal flap tear of the popliteal artery. (Reprinted with permission from Wascher DC: High-velocity knee dislocation with vascular injury: Treatment principles. Clin Sports Med. 19:472, 2000)

Figure 3.

Posterior-anterior radiograph of a posterior knee dislocation.

Figure 4.

Medial-lateral radiograph of a posterior knee dislocation.

Figure 5.

Arteriogram demonstrating vascular occlusion after multiple ligament knee reconstruction. (Reprinted with permission from Hegyes MS, Richardson MW, Miller MD. Knee dislocation: Complications of nonoperative and operative management. Clin Sports Med. 19:529, 2000)

Figure 6.

Skin blisters from excessive traction during wound closure. (Reprinted with permission from Hegyes MK, Richardson MW, Miller MD. Knee dislocation: Complications of nonoperative and operative management. Clin Sports Med. 19:533, 2000)

Figure 7.

Passive flexion done with hand placement to prevent posterior tibial drop-back.

Figure 8.

Passive knee flexion done with slight varus force to protect healing medial collateral ligament.

Figure 9.

Passive knee flexion done with slight valgus force to protect healing lateral collateral ligament.

Figure 10.

Passive patellar superior glide to ensure terminal knee extension motion.

Figure 11.

Passive patellar inferior glide to ensure full knee flexion motion.