Management and reconstruction strategies for multiligament knee injuries: Advances in diagnosis, surgical techniques, and rehabilitation

Background and Aims Multiligament knee injuries (MLKIs) are complex, high-stakes injuries often resulting from high-energy trauma, requiring precise diagnosis, tailored surgical planning, and structured rehabilitation to restore stability and function. This review examines strategies for MLKI management, highlighting Schenck’s classification system, physical assessment, imaging techniques, and graft choices. Materials and Methods A comprehensive literature search was conducted using PubMed, Embase, and Cochrane Library to identify studies on MLKIs, focusing on anatomy, diagnostic methods, and treatment approaches. Results Operative timing - acute, staged, and delayed - and decision-making between ligament repair and reconstruction are evaluated to optimize patient outcomes. In addition, advancements in graft selection and surgical techniques, such as double-bundle posterior cruciate ligament reconstruction, further enhance knee kinematics and reduce graft failure risk. The rehabilitation protocol focuses on balancing protection, early mobilization, and progressive strengthening to facilitate recovery and minimize complications like arthrofibrosis. Conclusion By integrating comprehensive treatment planning and patient-specific rehabilitation, MLKI management can significantly improve functional outcomes and patient satisfaction.