Abstract
Abstract
Background
Multi-ligament knee injury is a rare but severe injury. Treatment strategies are challenging for most orthopedic surgeons & optimal treatment remains controversial. The purpose of our study was to assess clinico-radiological and functional outcomes after surgical management of multi-ligament knee injuries & to determine factors that could predict outcome of surgery.
Materials And Method
It is a prospective observational study of 30 consecutive patients of Multi-ligament knee injury conducted between 2018–2020. All patients were treated surgically with single-stage reconstruction of all injured ligaments and followed standardized postoperative rehabilitation protocol. All patients were evaluated for Clinical (VAS score, laxity stress test, muscle-strength, range of motion), Radiological (stress radiographs) & Functional (Lysholm score) outcomes three times-preoperatively, post-operative 3 & 12 months.
Results
At final follow up mean VAS score was 0.86±0.77. The anteroposterior & valgus-varus stress test showed ligament laxity >10mm (GradeD) in 93.3% patient which improved to <3mm (normal, GradeA) in 90% patients. Most patients (83.3%) had preoperative-range <100° and muscle strength of MRC Grade-3 which improved to >120° and muscle strength of MRC grade-5 at final followup. Lysholm score was poor (<64) in all patients preoperatively and improved to good (85–94) in 73.3%, excellent (>95) in 20% & fair (65–84) in 6.6% patients. The stress radiographs showed stable results for anterior/posterior & varus/valgus stress. All patients returned to their previous work. Factors that could predict outcomes of surgery are age, timing of surgery, type of surgery & associated injury.
Conclusion
Early complete single stage reconstruction can achieve good functional results with overall restoration of sports & working capacity. Positive predictive factors for good outcome are younger age, early surgery & appropriate rehabilitation.
