Multiligament Knee Injuries: A 15-Year Clinical and Epidemiological Analysis at a Tertiary Referral Center

TL;DR

This paper analyzes 15 years of multiligament knee injury cases at a hospital, focusing on treatment outcomes and complications.

Contribution

The study provides a clinical and epidemiological analysis of multiligament knee injuries using a tertiary care center's 15-year experience.

Findings

Traffic accidents were the most common cause of multiligament knee injuries.

Anatomical reconstruction using the LaPrade technique was used in 44% of cases with satisfactory outcomes.

Complications occurred in 20% of patients, including joint stiffness and ligament re-rupture.

Abstract

Introduction: Multiligament knee injuries (MLKIs) represent a significant diagnostic and therapeutic challenge and are most often the result of high-energy trauma. The LaPrade technique has become a reproducible option for anatomical reconstruction of the posterolateral corner. This study presents the experience of a tertiary care center in the management of these complex injuries.

Methods: A retrospective descriptive study was conducted on 25 patients with MLKIs treated between 2010 and 2023 at our tertiary care hospital. Demographic and clinical variables, injury type (Schenck classification), mechanism of injury, treatment, and complications were analyzed. Prognostic outcomes were categorized as good or fair-poor based on direct patient-reported assessment at the one-year follow‑up regarding overall functional status, without the use of validated functional scales. Data analysis was performed using R‑Statistics version 3.5.2 (R Foundation for Statistical Computing, Vienna, AUT).

Results: Around 80% of patients were male, with a mean age of 42.1 ± 11.8 years and a mean BMI of 26.8 ± 3.9 kg/m². Traffic accidents were the most common mechanism (56%), followed by sports injuries and falls (20% each). Knee dislocation (KD) V was the most prevalent injury type (40%). Anatomical multiligament reconstruction, primarily following the LaPrade technique, was performed in 44% of cases. Complications occurred in 20% of patients, including joint stiffness, condylar necrosis, and ligament re‑rupture.

Conclusion: Anatomical multiligament reconstruction provides satisfactory functional outcomes with a complication rate comparable to the literature. A multidisciplinary approach and early rehabilitation are essential to optimize functional recovery in complex knee injuries.