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BACKGROUND Traumatic knee dislocation is a rare but devastating knee injury. It is more often caused by high velocity than low velocity accidents (1). Often it is referred to as multi-ligament injury, as it typically results in a rupture of both cruciate ligaments and at least one additional peripheral knee structure such as the medial or lateral collateral ligament. Furthermore, a multi-ligamentous injury is often accompanied by injuries of the menisci, capsule and less frequently by fractures and neurovascular lesions (2). Treatment of such multi-ligament injuries is either a direct primary repair or reconstruction of all or parts of the injured ligaments. In sedentary patients with low functional demands immobilisation in a brace might be an option. The time interval from injury has been considered an important factor for outcome in this challenging group of patients, which is documented in a considerable number of studies. However, the patients’ age as negative prognostic factor is still under debate. Age is an important factor in several modern therapeutic decision-making systems in orthopaedic surgery. Generally, one can state that with increasing age the healing capacity of soft tissue decreases and this then might lead to inferior outcomes. Traditionally a higher age at time of injury is considered as worse prognostic factor, albeit data is lacking for patients with multi-ligament injured knees. Most studies on multi-ligament injured knees did not investigate the influence of age on clinical outcomes (3-12). Hence, it was the purpose of this study to perform a single-centre retrospective study and compare the long-term outcomes of younger and older patients. It was hypothesized that patients’ age has a significant influence on subjective and objective clinical and functional outcomes after multi-ligament injuries to the knee. CORRESPONDING AUTHOR Michael T. Hirschmann Kantonsspital Baselland (Bruderholz, Liestal, Laufen) Department of Orthopaedic Surgery and Traumatology CH-4101 Bruderholz, Switzerland Phone: +41 7651 05 865 Fax: +41 6143 63 676 E-mail: Michael.Hirschmann@unibas.ch

Multi-ligament injures of the knee: does the age matter? A long-term retrospective study