Primary repair in acute multiligamant knee injury

Anshu Shekhar, Siddharth Reddy, Sachin Tapasvi

Volume 5 | Issue 1 | Jan – April 2020 | Page 14-19

Author: Anshu Shekhar [1], Siddharth Reddy [1], Sachin Tapasvi [1]

[1] The Orthopaedic Speciality Clinic, Pune

Address of Correspondence
Dr. Anshu Shekhar,
The Orthopaedic Speciality Clinic, Pune
E-mail: dr.anshushekhar@gmail.com

Abstract

Acute multilagment knee injuries (MLKI) are those in which more than two ligaments are injured and which present within a period of three weeks. Treatment of life threatening conditions, neurovascular injuries, peri-articular fractures and irreducible dislocations take precedence over ligaments in setting of an acute MLKI associated with or without knee dislocations. There is no consensus or well defined guidelines regarding management of these complex injuries. For medial sided injuries, early repair for avulsions with good tissue quality and reconstruction for mid substance tears or poor tissue quality is a reasonable approach. Early repairs of posterolateral corner structures have had good functional outcomes but failure rates of such repairs are higher compared to a reconstruction. Better stability and better knee range of motion have been reported in knees with cruciate reconstructions than repairs in an acute setting. Primary suture repair in indicated low demand patients has shown promising outcomes. However, the risks of arthrofibrosis and revision surgery must be explained to the patients undergoing and arthrotomy for cruciate repairs. Use of synthetic augmentation seems reasonable although there is no strong science to support this presumption. A comparative study between homogenous injury groups would perhaps shed more light on the relevance of repair or reconstruction in acute surgery for MLKI.
Keywords: Knee dislocation, Multiligament knee injury, Acute, Ligament repair, Ligament reconstruction.

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