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Introduction: Multi-ligament knee injuries (MLKIs), involving damage to two or more major knee ligaments, present complex challenges in orthopedic surgery due to the intricacy of the injury and its significant impact on knee stability and function. These injuries often require specialized treatment strategies, with two-stage surgical reconstructions emerging as a viable option. This report examines a case of MLKI and the outcomes of a staged surgical approach to repair and reconstruct the affected knee ligaments.
Case Report: A 55-year-old female sustained a multi-ligament injury to her right knee after a twisting event, resulting in pain, swelling, and instability. The patient underwent a two-stage arthroscopic reconstruction, beginning with repair of the posterior cruciate ligament and posterolateral corner structures, followed by anterior cruciate ligament reconstruction. Autografts, including the bilateral peroneus longus and contralateral hamstrings, were used for the procedure. Her rehabilitation protocol emphasized early passive range of motion exercises, with delayed weight-bearing to promote effective healing.
Conclusion: This case demonstrates the successful restoration of knee stability and function following a two-stage surgical approach to MLKI. The case underscores the need for individualized treatment plans and highlights the potential benefits of a phased procedure. While promising, further research is required to compare single-stage and two-stage approaches and to assess their long-term outcomes in managing complex MLKIs.
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http://dx.doi.org/10.13107/jocr.2025.v15.i05.5608 | DOI Listing |
Knee Surg Sports Traumatol Arthrosc
September 2025
Department of Orthopedic Surgery, APHM, CNRS, ISM, Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix Marseille University, Marseille, France.
Purpose: Slope-reducing high tibial osteotomies (SR-HTOs) correct posterior tibial slope (PTS) abnormalities in patients with anterior knee instability, as in cases of anterior cruciate ligament (ACL) deficiency. The SR-HTO techniques, including infra-tubercle and retro-tubercle approaches, provide distinct benefits: retro-tubercle techniques help preserve patellofemoral joint mechanics, while infra-tubercle techniques are effective in mitigating iatrogenic varus. However, there is limited comparative literature available.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2025
Department of Orthopaedic Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Purpose: This study aims to characterize the mechanism of multi-ligament knee injury (MLKI) sustained during a National Football League (NFL) game through video analysis.
Methods: A retrospective video analysis of official NFL game footage spanning 1997-2022 was performed. Players with MLKIs were identified from publicly available injury surveillance data.
Med Sci (Basel)
August 2025
Complex Operational Unit of Sports Medicine and Joint Reconstruction, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00136 Rome, Italy.
Purpose: To evaluate the prevalence of undiagnosed ligamentous knee injuries in patients surgically treated for high-energy pelvic ring or acetabular fractures and propose a mechanism to diagnose these briefly post-hospital discharge.
Methods: A retrospective case series (level of evidence IV) was conducted at Italy's largest trauma center. Medical records from 2018 to 2023 were reviewed to identify patients who underwent surgical treatment for pelvic or acetabular fractures.
J Orthop
October 2025
University of Miami Miller School of Medicine, Department of Radiology, Division of Musculoskeletal Radiology, Miami Dade, FL, USA.
Knee arthroscopy is a common and generally safe procedure for treating ligamentous, meniscal and cartilaginous knee injuries, yet rare complications such as irrigation fluid extravasation and compartment syndrome can occur when the posterior joint capsule is violated. Because posterior capsular injury is often under-recognized on clinical examination and conventional MRI, failure to identify these tears may lead to instability, accelerated cartilage degeneration and functional limitations. In this narrative review, we first outline the complex anatomy of the posterior capsule, including its integration with the semimembranosus and popliteus complexes and attachments to cruciate ligaments, and then characterize key injury mechanisms (multi-ligament tears, pivot-shift, dashboard, hyperextension and valgus "clip" injuries).
View Article and Find Full Text PDFKnee
August 2025
Department of Orthopaedic Surgery, University of New Mexico, Albuquerque NM, USA.
Background: Knee dislocations (KD) are devastating injuries that are known to predispose to post-traumatic arthritis of the knee. While some patients will require total knee arthroplasty (TKA), there is limited literature on outcomes of TKA following KD. The purpose of this study is to compare surgical characteristics and outcomes between patients undergoing TKA following KD versus those undergoing TKA for osteoarthritis.
View Article and Find Full Text PDF