Clinical outcomes after multiligament injured knees: medial versus lateral reconstructions

Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):524-531. doi: 10.1007/s00167-016-4067-4. Epub 2016 Mar 21.

Abstract

Purpose: The purpose of this study was to analyse the clinical outcomes of multiligament injured knees with respect to the medial collateral ligament and posteromedial corner (PMC) repair or reconstruction versus the posterolateral corner (PLC) reconstruction in patients operated according to a codified surgical protocol.

Methods: Patients were divided into two groups depending on whether PMC or PLC was injured. Cruciate ligaments as well as PMC or PLC were reconstructed/repaired in a one-stage procedure. At minimum of 1-year follow-up, objective and subjective International Knee Documentation Committee (IKDC) forms, Lysholm score and sports activity level were recorded.

Results: Thirty-nine patients with a median follow-up time of 57 months (range 12-129) were reviewed. No significant difference was found for functional scores between acute PMC and PLC subgroups. In Group PLC, subjective outcomes tend to be better in the acute than in chronic reconstruction subgroup.

Conclusions: A one-stage protocol with early surgery rather than delayed reconstruction produced better clinical outcomes whatever the injured collateral ligament, medial or lateral. In the future, early and chronic reconstructions as well as each injury pattern should be considered as separate entities in studies on multiple ligament injured knees to reach a better level of evidence.

Level of evidence: IV.

Keywords: Multiligament injured knees; Posterolateral corner; Posteromedial corner.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anterior Cruciate Ligament Injuries / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Dislocation / etiology
  • Knee Dislocation / surgery*
  • Lysholm Knee Score
  • Male
  • Medial Collateral Ligament, Knee / injuries
  • Medial Collateral Ligament, Knee / surgery*
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Posterior Cruciate Ligament / injuries
  • Posterior Cruciate Ligament / surgery*
  • Range of Motion, Articular
  • Tibial Meniscus Injuries / surgery*
  • Young Adult