Outcome of Single-Stage Multiple-Ligament Knee Reconstructions for Traumatic Knee Injuries

Abstract Introduction: Multi-ligament knee injuries (MLKI) present in various combinations of structures around the knee joint, with or without involvement of neurovascular structures, posing significant challenges to the treating physician and therapists. Accurate diagnosis with appropriate surgical intervention and comprehensive rehabilitation to restore function and stability is, therefore, paramount. Single stage multiple-ligament knee reconstructions have emerged as a pivotal technique in addressing these intricate injuries, aiming to restore knee stability and function, and thereby facilitating return to sports or work. This article deals with the outcomes of such surgical interventions, focusing on the efficacy, and rehabilitation timelines following single-stage reconstructions. In our study, we followed a comprehensive approach to address traumatic knee injuries, especially those involving multiple ligaments. The goal of our surgical intervention was to restore knee stability and function, while our rehabilitation protocol aimed at ensuring optimal recovery and return to work. Discussion: Studies have demonstrated that single-stage reconstructions can effectively restore knee stability, as assessed by objective measures such as the Lachman test, anterior & posterior drawer test, Varus & Valgus stress tests and postoperative imaging. Functional outcomes, often gauged through tests like the Lysholm Knee Scoring Scale and the Tegner Activity Level Scale, have also shown promising results, with many athletes achieving near pre-injury levels of knee function. Postoperative rehabilitation protocols following single-stage reconstructions are tailored to balance the healing of reconstructed ligaments while progressively restoring range of motion, strength, and functionality of the knee. The duration and intensity of rehabilitation is pivotal in determining the success of the reconstruction and the timeline for return to daily life or sports. Conclusion: Single-stage multiple-ligament knee reconstruction represent a significant advancement in the treatment of complex knee injuries in athletes. While promising in terms of restoring stability and function, the approach demands careful consideration of surgical techniques, a meticulously planned rehabilitation protocol, and a holistic understanding of the patient's goals and psychological readiness for return to work. Future research is essential to optimize these protocols and further enhance outcomes for athletes suffering from MLKIs.