Summary

Multligament knee injuries are complex injuries requiring detailed analysis, concise diagnosis and complex reconstruction taking up to 2 years to reach maximal clinical improvement

Abstract

Introduction

The majority of Multi-ligament Knee (MLK) studies have presented limited outcome measures in small cohorts, with larger datasets required to better demonstrate the true post-operative recovery in such a heterogenous cohort, along with factors that may be associated with recovery.

Methods

A consecutive series of 147 patients undergoing MLK reconstruction between September 2015 and March 2022 were identified with information collected on surgical techniques, grafts, concomitant surgical procedures, patient demographics and injury history. While the pre-injury Tegner score was obtained, patients were assessed post-operatively using the Tegner, Lysholm and International Knee Documentation Committee (IKDC) scores at 3, 6, 12 and, 24 as well as 5 years. Surgical complications and revisions were identified.

Results

A mean age of 35.2 (SD 11.4, range 58) and BMI of 27.8 (SD 6.08, range 36.1) was observed, with a mean time from injury to surgery of 53.5 days (SD 100.4, range 727). In the 147 patients included, 62 (42%) were sporting injuries, with 54 (37%) motor vehicle accidents and 31 (21%) through other modes (i.e. falls, work accidents). A significant improvement (p < 0.05) over the post-operative timeline was observed for all outcomes, though the mean Tegner at 3 months (mean 2.7) and 5 – years (mean 4.8) was significantly lower than the pre-injury Tegner of 6.7. A range of complications and secondary surgical procedures were observed.

Conclusion

Despite variable patient factors such as age, BMI, mechanism and severity of injury, time to surgery and surgical complications; results suggest patients recover with sound functional outcomes at 5 years.