Surgical Management of the Multiple-Ligament Injured Knee: a Case Series from Chongqing, China and Review of Published Reports

Objective: The correct management of multiple-ligament injured knees (MLIKs) remains controversial. This study aimed to summarize the epidemiological features and short-term results of patients treated in our department. Methods: Sixty-six patients diagnosed with MLIKs from 2009 to 2011 were enrolled. Relevant patient characteristics and clinical variables were analyzed to characterize the epidemiology. A surgical algorithm based on a knee dislocation classification system and postoperative rating scales, including Lysholm and Tegner rating, as well as joint mobility, stability and radiography were collected for functional evaluation at 2.5-year follow-up. Results: The epidemiological profile demonstrated that 30- to 50-year-old men were at the highest risk. The primary causes were vehicle accidents and falls and most common injury type cruciate combined collateral ligament injuries. Final follow-up analysis comparing operative versus conservative management and surgically treated mild versus severe MLIKs showed significant differences in Lysholm and Tegner scale scores, as well as knee mobility and stability. Conclusion: The therapeutic outcome of MLIKs depends on various clinical variables and a surgical algorithm. Satisfactory restoration of function was acquired in the majority of our surgically treated MLIK cases; however, most patients had not achieved their pre-injury activity levels by the follow-up endpoint.