Best Practice Case Studies-The Multiligament Injured Knee

Pdf Summary

This systematic review, led by Giovanni Vicenti and colleagues, explores the treatment of multiligament knee injuries, focusing on critical aspects such as surgical versus nonoperative treatment, repair versus reconstruction of injured ligaments, and timing of surgery (early versus late). The researchers searched PubMed from 1966 to 2016, compiling studies with at least 12 months of follow-up and comparing functional and clinical outcomes in knee injuries involving at least two major ligaments.<br /><br />The review found that surgical treatment generally resulted in better outcomes than nonoperative management, with higher Lysholm scores and return-to-sport rates. Reconstruction of ligaments, as opposed to repair, also showed improved results, particularly for the posterolateral corner, where repair had a higher failure rate. Studies indicated that early surgical intervention (within three weeks of injury) led to superior functional outcomes in comparison to delayed surgery.<br /><br />Despite the evidence pointing towards reconstruction and early surgery, the review acknowledges the lack of high-quality data due to the rare occurrence of multiligament knee injuries and varied injury patterns. Most studies reviewed had retrospective designs, potentially introducing selection bias. <br /><br />The review concludes that while there is no universally best treatment approach, reconstruction appears to offer better clinical outcomes than repair, and early surgical intervention is preferable. Delayed procedures could help address issues like arthrofibrosis in certain cases, suggesting staged treatment might also be beneficial. The findings emphasize that each treatment plan should be tailored to the individual patient’s conditions and injury characteristics.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, CASE 28

Topic Knee

Keywords

2nd Edition

multiligament knee injuries

surgical treatment

nonoperative management

ligament reconstruction

early surgery

functional outcomes

posterolateral corner

retrospective studies

arthrofibrosis

individualized treatment

2nd Edition, CASE 28

Knee