Which treatments are available for multiligament injuries?

Multiligament knee injuries are injuries that result in sprains or tears in two or more of the major ligaments surrounding the knee. Multiligament injuries of the knee are relatively rare and often occur as the result of a high energy trauma such as a car accident or a contact sports injury. Multiligament injuries are also often associated with knee dislocations because the separation of the thigh bone and shin bone causes ligament tears. These injuries, while uncommon, are serious and often lead to knee pain, swelling, instability, and sometimes even nerve injury. Due to their severity, multiligament injuries require prompt medical care.

In some cases, it is possible that some of the knee ligaments may heal without surgery. However, for most patients, surgery is typically recommended early on. Usually, patients undergo reconstruction with grafts. Since multiple ligaments require reconstruction, allografts are usually preferred over autografts to prevent donor site morbidity. These procedures usually require a one night hospital stay to monitor recovery and pain. For certain patients with severe obesity and advanced age, conservative treatment with immobilization and rehabilitation may be more appropriate and still yield adequate stability.

Following surgery there is also a period of rehabilitation. After an initial period of immobilization, patients start weight bearing, passive/active range of motion exercises, and strength exercises. The rehabilitation is extensive, but with commitment to a good rehabilitation program, patients may return to sports and previous levels of activity 9 to 12 months post-surgery.

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