Summary

The single-stage anatomic-based knee ligament reconstructions with immediate postoperative rehabilitation yielded significantly improved outcomes irrespective of the ligament injury pattern.

Abstract

Introduction

Outcomes after single-stage multiple-ligament knee reconstructions are not well-documented. This study aimed to evaluate the clinical and radiological outcomes following single-stage surgical treatment of knee dislocations associated with multiple-ligament injuries.

Methods

The study included skeletally mature patients who had at least two major knee ligaments torn and underwent single-stage multiple-ligament reconstruction, with a minimum follow-up period of 1 year. Patient-Reported Outcome Measurements (PROMs), including the International Knee Documentation Committee (IKDC) score and Single Assessment Numeric Evaluation (SANE) score, were collected preoperatively and at a minimum of 6 months and 1 year postoperatively. Clinical data, such as range of motion (ROM) and knee stability, were recorded at the final follow-up. Radiological data, including postoperative side-to-side differences on stress views and MRI, were assessed at the 1-year follow-up.

Results

A total of 20 patients who experienced knee dislocations with multiple-ligament injuries between 2021 and 2024 were identified. The mean follow-up period was 14 months. There was a significant improvement in all postoperative PROMs compared to preoperative values (p < 0.001 for all scores). Specifically, the IKDC score improved from 20 to 70, and the SANE score improved from 10 to 65. Postoperatively, the average ROM could achieve 127.5 degrees, and knee physical examinations indicated stability at the final follow-up. The side-to-side differences in postoperative stress views, including posterior, varus, and valgus stress, were 3.3 mm, 1.2 mm, and 2.2 mm, respectively. MRI at the 1-year follow-up showed that all grafts healed. No significant differences were found in postoperative clinical and radiological outcomes between patients treated in the acute versus chronic phases.

Discussion

This study presents clinical and radiological outcomes for patients who underwent single-stage multiple-ligament knee reconstruction. The findings demonstrate that single-stage, anatomic-based knee ligament reconstructions, combined with immediate postoperative rehabilitation, result in significantly improved outcomes regardless of the ligament injury pattern.