Multi-Ligament Knee Injuries Treatment Options

Can a multi-ligament knee injury be treated without surgery?

Multi-ligament knee injuries typically do not heal on their own. In these injuries, the knee is very unstable. In order to restore knee function and stability, surgery is required.

What are the surgical options for a multi-ligament knee injury?

Whenever possible, surgery within the first two weeks after a knee dislocation is recommended to stabilize the knee if satisfactory range of motion has been achieved. Attempting to operate on a stiff knee can jeopardize the outcomes of the procedure. In healthy patients with an acceptable range of motion, who do not have any lacerations or problems around the area of the knee dislocation, surgery is indicated to reconstruct the injured structures.

Surgery for a knee dislocation resulting in a multi-ligament knee injury is serious. Reconstructing the torn ligaments and repairing the torn menisci (if present) in one surgery works best so as to not put too much stress on any one graft/reconstruction. Therefore, it is essential that surgery is performed in an efficient manner that minimizes the anesthesia and surgical time. Dr. Chahla is the complex multi-ligament knee surgeon at Midwest Orthopaedics at Rush. Dr. Chahla and his surgical team routinely perform multi-ligament reconstructions and have implemented a practice within the operating room that optimizes efficiency and mitigates the total surgical time, enhancing patient outcomes.

What is the prognosis after knee dislocation surgery?

In general, most sports-related knee dislocations heal well after surgery. The incidence of artery injury is less than 1 percent, and multi-ligament reconstruction surgery is usually effective.

The results for high-velocity knee dislocations are less predictable because of the amount of injury to soft tissues and other structures. These patients may need to be followed more closely to ensure that their knee motion is progressing appropriately without developing significant stiffness and that their knee ligament reconstructions do not stretch out because of other soft tissue injuries.

Because of the significant trauma associated with a knee dislocation, most patients will start to develop arthritis within ten years. This is probably a result of some of the cartilage cells being killed or significantly damaged during the initial impact. Unfortunately, there are not great options to treat this other than to ensure that the patient restores their muscle mass. Restoring muscle mass allows patients to have better shock absorption with everyday activities, better preserving the overall health of the knee joint. Preserving the torn menisci is also essential. If the meniscus needs to be taken out, the risk of later osteoarthritis is significantly increased.