Open AccessManagement of multiligament knee injuries
Author(s) -
J. Ng,
Yulanda Myint,
Fazal Ali
Publication year - 2020
Publication title -
efort open reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.588
H-Index - 22
ISSN - 2396-7544
DOI - 10.1302/2058-5241.5.190012
Subject(s) - knee dislocation , medicine , surgery , medial collateral ligament , ankle , palsy , posterior cruciate ligament , range of motion , ligament , anterior cruciate ligament , alternative medicine , pathology
Up to 18% of multiligament knee injuries (MLKI) have an associated vascular injury. All MLKI should be assessed using the ankle brachial pressure index (ABPI) with selective arteriography if ABPI is < 0.9. An ischaemic limb following knee dislocation must be taken to the operating theatre immediately for stabilization and re-vascularization. Partial common peroneal nerve (CPN) injury following MLKI has better recovery than complete palsy. Posterior tibial tendon transfer is offered to patients with complete CPN palsy if there is no recovery at six months. Operative treatment with acute or staged reconstructions provides the best outcome in MLKI. Effective repair can only be performed within three weeks of injury. There is no difference between repair and reconstruction of medial collateral ligament and posteromedial corner. Posterolateral corner reconstruction has a lower failure rate than repair. Early mobilization following MLKI surgery results in fewer range-of-motion deficits. Cite this article: EFORT Open Rev 2020;5:145-155. DOI: 10.1302/2058-5241.5.190012