An Overview on Multi-Ligament Knee Reconstruction
A multi-ligament knee injury is quite common in athletes and is considered a complex knee injury in most cases. More than one ligament can sustain an injury when placed under severe trauma, such as a sports injury, a fall from height or an automobile accident. There are four main ligaments present in the knee that all have their own function and aid in knee stability, including the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and posterior lateral complex (PLC). A multi-ligament knee injury is defined as an injury to two or more of the knee ligaments. This complex knee injury is considered a medical emergency because of the potential of nerve and/or blood vessel damage. If a multi-ligament knee injury is suspected, emergency room evaluation should be performed. If a patient experiences one of these injuries, a ligament reconstruction is typically needed to stabilize the knee joint.
Before performing a ligament surgery, Dr. Waterman will perform a medical review and physical examination to review the knee’s ligament damage and injury pattern. X-rays and an MRI scan will also be used to detail the extent of ligament damage. In most cases, the reconstruction is performed within two weeks of injury to allow for easier identification of the normal anatomic structures prior to extensive scar formation. Each patient will represent a unique knee surgery approach. Some patients may have one ligament that will heal on its own with another ligament requiring reconstruction, while some patients will need a complete reconstruction of one or more ligaments. During the ligament surgery, Dr.Waterman will repair the damaged ligaments that require surgical treatment using a graft or multiple grafts from the patient or a donor to secure the ligaments and structures back into place. Multi-ligament knee reconstruction is commonly performed by Dr.Waterman in one procedure with a combination of arthroscopic and open surgery techniques to thoroughly correct all of the damaged areas. Depending on the exact circumstances and injury pattern, occasionally a two stage surgical approach is undertaken.
Recovery and Rehabilitation after Multi-Ligament Knee Reconstruction
Multi-ligament knee reconstruction is a complex knee surgery and an intensive and detailed rehabilitation program is critical to a patient’s recovery. Dr.Waterman will instruct all patients to begin physical therapy early following the knee surgery procedure even though knee range of motion may be limited for a specific amount of time. The use of a knee brace and therapy progression are dependent on each patient, their injury extent and extent of ligament surgery. In most cases, a knee brace, cryotherapy sleeve and crutches are required for the first four to six weeks after the surgery. Knee range of motion should be regained by twelve weeks after surgery at which time strengthening is initiated. In most cases, maximum improvement can be expected 8-12 months following the repair.