Multi-Directional knee instability refers to a knee that is grossly unstable. While almost always due to several ligaments being injured in a knee dislocation, it can also occur in patients with significant joint laxity, such as those with Ehlers-Danlos syndrome.
The treatment of multidirectional instability can be very complicated. In addition to determining the patient’s symptoms to determine whether observation, bracing or surgery is indicated, a complex work-up to determine the timing of the injury (to determine if it is an acute or chronic injury), the specific ligaments that are injured (most reliably measured on stress x-rays), and also looking at a patient’s alignment and tibial slope may be indicated. In addition, the underlying cause of the instability has to be determined to help decide if one or two surgeries may be necessary to address the problem. In general, the treatment of multidirectional knee instability should be performed by an experienced surgeon who has an experienced surgical team, to maximize the patient’s outcome.
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