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FUNCTIONAL OUTCOME FOLLOWING RECONSTRUCTION IN MULTIPLE LIGAMENT DEFICIENT KNEES



Abstract

Multiple ligament deficiency in knees is usually the aftermath of high velocity trauma and leads to complex multidirectional instability, that can in turn greatly compromise the patient’s functional level if left untreated. The aim of this study is to evaluate the mid- and long-term functional outcome of patients who underwent complex reconstruction for multiple ligament deficiency.

Twenty-nine patients (21 male and 8 female) with an average age of 35.54 years (range 17–60) underwent arthroscopic or arthroscopically assisted multiple ligament reconstruction at an average of 2.1 years following their initial knee injury. Thirteen of them sustained a multiple ligament injury following an RTA, 11 during sports and 5 following a fall from a height.

They were followed for a period of 13 to 108 months (average: 45.8) and functionally evaluated according to Clancy’s criteria. The functional outcome was excellent in five patients (17.2%), good in ten (34.5%), fair in twelve (41.4%), while two reconstructions resulted in a failure (6.9%). Eleven patients returned to sporting activities and all but three returned to work, although sometimes in lighter duties.

Arthroscopic multiple ligament reconstruction is a complex and technically demanding procedure that should be carried out in specialised units. Although it rarely results in a “normal” knee, it offers in most cases a stable as well as functional knee.

Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN