A complex knee injury occurs when more than one ligament within the knee has been damaged. The major knee ligaments are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the fibular collateral ligament (FCL).
A multi-ligament injury is rare. In order to sustain this type of injury, the patient most often was involved in a major accident or very traumatic sporting fall or event. Complex knee surgery and multi-ligament knee surgery to repair this type of injury is complicated and oftentimes can only be optimally performed by a knee specialist who performs complex knee surgeries routinely.
Surgical Treatment for Complex Knee Injury
Almost all two-ligament injuries of the knee, except for combined ACL and MCL injuries, require a combined surgical reconstruction. Dr. LaPrade recommends performing a multiple ligament reconstruction all at one setting. This is because it is well recognized that each ligament depends upon other ligaments for overall stability and performing a reconstruction first for just a portion of the injury increases the risk of that ligament reconstruction stretching out. Dr. LaPrade’s surgical team is set-up such that the overall surgical procedure does not take an extended period of time and we strongly recommend the patient’s multi-ligament knee surgery be performed in one setting to allow the patient to move forward with their rehabilitation and their life.
Rehabilitation Following Surgery
An absolutely essential part of a multi-ligament knee surgery reconstruction is the postoperative rehabilitation. A very well done multi-ligament reconstruction can result in a less than ideal outcome if a concurrent supervised rehabilitation program is not followed. Thus, we believe it is essential for complex knee injury patients to start physical therapy the day after surgery, to work on range of motion and muscle reactivation immediately, and have the surgeon and physical therapist communicate directly to improve the patient’s outcome. We believe this will results in improved overall outcomes, less joint stiffness, and quicker return of muscle function.
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