Summary

This study highlights the impact of MLKI on patients' ability to return to their previous levels of sports and work. A significant number of patients were unable to return to their former sports activity, and while the majority of patients were able to return to work, a significant proportion had to transition to lighter or less physically demanding jobs or became disabled due to the injury.

Abstract

Objectives
Multiligament knee injuries (MLKI) are serious injuries that can have impact on knee function and ultimateely affect patient's ability to return to their previous sports activity level and employment. This study aimed to investigate the return to sports and work after surgical treatment of MLKI.

Methods

This cross-sectional cohort study included patients who underwent surgical treatment for MLKI at a single level 1 Trauma center between January 2013 and December 2020. Sports participation was measured using the Tegner score, along with details of the types of sports undertaken. To assess return to work, patients were asked to provide information about their work situation before and after the injury. The patient-reported outcomes included also EuroQol 5D 5 (EQ-5D), a widely used measure of health-related quality of life.

Results

The study identified 191 patients treated during the study period, with 124 (65%) providing a complete data set at a mean follow-up time of 74 ± 27 months. Of these, 68 were male, and 56 were female, with a mean age of 44 ± 13.6 years. The most common injury pattern involved a multiligament with a single cruciate ligament (51%), while 49% involved bicruciate injuries.

The overall rate of return to any work was 90%, but ten (8%) patients returned to less demanding tasks due to the knee injury, and 11 (5%) patients became disabled. Nineteeen percent of the patients changed jobs to less physically demanding jobs after surgery (p<0.001), but there was no significant difference (p=0.713) between single cruciate and bicruciate ligament injury regarding the type of work after injury. The overall rate of return to some level of regular sporting activity was 68%. The Tegner activity scores indicated a decrease in activity level postoperatively (3 ± 2.2) compared to preoperatively (5.2 ± 2.7); (p<0.001). However, 44 (36%) patients returned to the same pre-injury sports level. Patients with single cruciate injuries had significantly higher scores on Tegner compared to patients with bicruciate ligament injuries 3.6 (±2.2) vs. 3 (±2.2), p=0.043). Patients reported a health scale index of 74 ± 16.3.

Conclusion

This study highlights the significant impact of MLKI on patients' ability to return to their previous levels of sports and work. A significant number of patients were unable to return to their former sports activities, with only one-third resumed their former sports participation. Although the majority of patients were able to return to work following MLKI, a significant proportion had to transition to lighter or less physically demanding jobs, or became disabled due to the injury.