Multi-ligament Knee Injuries
What are multi-ligament knee injuries?
The knee consists of four main ligaments: the anterior cruciate ligament, the posterior cruciate ligament, the medial collateral ligament and the fibular (lateral) collateral ligament. These ligaments work together to keep the knee stable as you walk, pivot, turn or play sports. Most knee ligament injuries – such as an ACL tear – involve a single ligament. Multi-ligament knee injuries affect two or more ligaments at the same time. If three or all four of the major ligaments are injured, the knee may be dislocated. Multi-ligament knee injuries are usually quite severe and can lead to significant instability of the knee.
How do multi-ligament knee injuries occur?
Multi-ligament knee injuries tend to occur in high-impact sports where people are struck or tackled, such as football. Other causes include traumatic injury, a direct blow to the knee, skiing or automobile accidents, or a fall from a height.
What are the symptoms of multi-ligament knee injuries?
Multi-ligament knee trauma is an intricate injury pattern that produces a range of symptoms, including:
- Severe pain
- Swelling of the knee
- Knee instability
- Inability to walk
- Lack of control of the limb
- Damage to nerves or arteries in the leg, especially if the knee is dislocated
How are multi-ligament knee injuries diagnosed?
Multi-ligament knee injuries are usually quite complex and demand good clinical acumen to recognize. In addition to a careful physical exam and patient history, stress radiographs (x-rays in which your surgeon carefully manipulates your knee while obtaining the image to help guide treatment) and MRI are the most effective tests to help the surgeon confirm the diagnosis.
What is the treatment?
The sooner the injury is treated, the better the results. Early treatment allows for improved function during the healing process, return to an active lifestyle and a decrease in the progression of arthritis in the future. For most patients, surgery is required to reconstruct the ligaments. Because the procedure is so complex, meticulous planning is necessary beforehand to avoid technical pitfalls. Grafts are used to replace a completely torn or deficient ligament and restore the anatomy of the knee. The graft is made from the patient's own tissues (known as an autograft) or from donor tissues (known as an allograft).
Following multi-ligament knee reconstruction, patients usually wear a brace and do not put any weight on the knee for approximately six weeks. A robust physical therapy program is necessary to regain, flexibility, stability and strength. As with all surgical procedures, specific recovery time varies by patient and demand.