Abstract
Background
Treatment of multiple ligament-injured knees (MLIKs) remains complex and most often
requires ligament reconstruction surgery. Reconstruction effectively restores knee
stability but the procedure is invasive and can be complicated by stiffness or arthrofibrosis.
There has been recent resurgence of interest in primary repair of knee ligaments.
The goal was therefore to assess incidence of repairable ligaments in MLIKs, and determine
patient and injury characteristics associated with potential for primary repair.
Methods
A retrospective review of all MLIK patients surgically treated between 2009 and 2018
was conducted. All patients were treated with the same algorithm: primary repair was
performed if the ligament was proximally or distally avulsed, and otherwise, reconstruction
was performed. Patient characteristics, injury patterns, treatment specifics, and
short-term outcomes were compared using independent t-tests and chi-square tests.
Results
Forty-eight patients were included (mean age 32 years ± 14; 54% were male). Ultimately,
55% of ACL, 73% of PCL, 88% of MCL/PMC, and 87% of LCL/PLC injuries were repaired.
Patients above 35 years (OR 6.9, P = 0.010) and higher BMI (OR 3.5, P = 0.046) were more likely to undergo ACL repair. No significant correlation was found
in other ligaments. At a minimum of six-month follow-up (range 0.5–7.2 years), ACL
repair failed in nine percent, PCL repair in 17%, MCL/PMC repair in 0%, and LCL/PLC
repair in 18% of patients.
Conclusions
This study noted high incidences of repairable ligaments when MLIKs are treated within
six weeks following injury. Although preliminary outcomes following primary repair
in MLIK are good, further long-term follow-up studies are needed.
Keywords
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Article info
Publication history
Published online: January 13, 2020
Accepted:
November 23,
2019
Received in revised form:
October 23,
2019
Received:
June 5,
2019
Identification
Copyright
© 2019 Published by Elsevier B.V.
