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. 2019 Jul;7(4):346-353.

Short to Mid-term Outcomes of Single-stage Reconstruction of Multiligament Knee Injury

Abolfazl Bagherifard  1   2 , Mahmoud Jabalameli  1   2 , Salman Ghaffari  1   2 , Jafar Rezazadeh  1   2 , Majid Abedi  1   2 , Masoud Mirkazemi  1   2 , Javad Aghamohamadi  1   2 , Afshin Hesabi  1   2 , Mehdi Mohammadpour  1   2
Affiliations

Short to Mid-term Outcomes of Single-stage Reconstruction of Multiligament Knee Injury

Abolfazl Bagherifard et al. Arch Bone Jt Surg. 2019 Jul.

Abstract

Background: Multiligament knee injury (MLKI) is a complex orthopedic injury leading to the tear of at least two of the major knee ligaments. However, there is no consensus on the optimal management of this debilitating condition. Regarding this, the present study was performed to evaluate the outcomes of single-stage multiligament reconstruction surgery in patients with MLKI.

Methods: This retrospective study was conducted on 41 consecutive MLKI patients who underwent surgical reconstruction. Objective evaluation of the outcome included active extension and flexion. Furthermore, the subjective evaluation of the outcome was accomplished using the Lysholm scoring scale and International Knee Documentation Committee (IKDC) form in Persian. Postoperative complications were also recorded for all patients.

Results: The mean age of the participants was 31.95±7.82 years. In addition, the mean follow-up period and the mean time interval between the injury and surgery were recorded as 36.9±17.8 and 11.5±8.9 months, respectively. The mean Lysholm and IKDC scores were obtained as 86.9±11.5 and 70±18.7, respectively. The mean Lysholm and IKDC scores were not statistically different between the patients who underwent surgery less than 6 months after the injury and those subjected to reconstruction 6 months postinjury (P=0.07 and P=0.3, respectively). Seven patients showed postoperative restricted range of motion, which was resolved with physiotherapy. The only surgical complication was popliteal artery injury.

Conclusion: As the findings indicated, the single-stage reconstruction of MLKI provided an acceptable outcome. However, several aspects of this reconstruction, such as the timing of the surgery, still remain to be resolved in future investigations.

Keywords: Complication; Multiligament knee injury; Outcome; Reconstruction surgery.

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Figures

Figure 1
Figure 1
Anterior-posterior radiograph of a multiligament right knee injury under valgus stress test, complicated with peroneal nerve injury in association with posterolateral corner damage
Figure 2
Figure 2
(A) Anterior-posterior radiograph of the injured right knee under valgus stress test, (B) lateral radiograph of the same knee with manual posterior drawer test, (C) anterior-posterior plain radiograph of the same knee after reconstruction failure, (D) anterior-posterior plain radiograph of the same knee after the second surgery (anterior cruciate ligament+posterior cruciate ligament+posterolateral corner‏, and (E) lateral plain radiograph of the same knee after the second surgery
See this image and copyright information in PMC

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