Early Open Repair of a Multiligamentous Knee Injury

SUMMARY: This review discusses the utility of early open repair of multiligamentous knee injuries in patients with high-energy mechanisms. The surgical technique for anterior cruciate ligament, posterior cruciate ligament, and medial collateral ligament repair was demonstrated on a polytraumatized patient using the medial parapatellar approach. The posterior cruciate ligament was repaired first with suture through a drill tunnel in the femoral insertion followed by the anterior cruciate ligament in a similar fashion. The medial collateral ligament was repaired last with a staple. With some exceptions, weight bearing and knee range of motion are permitted immediately postoperatively. In the right patient population, this procedure may expedite patients' recovery and return to daily life.