Modern multiligament knee injury surgical reconstruction techniques can achieve excellent knee function and patient satisfaction, with low complication rates

Alistair I.W. Mayne (Lead / Corresponding author), Jay R. Ebert, Peter K. Edwards, Peter S.E. Davies, Robert Evans, Randeep S. Aujla, Shahbaz S. Malik, Michael J. Grant, Stephen Dalgleish, Satyen Gohil, Peter D'Alessandro

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Purpose 

To report on the recovery of strength and functional capacity symmetry following multiligament knee surgical reconstruction (MLKR), as well as the capacity of athletes to return to sport. 

Methods 

This prospective cohort study recruited 47 patients undergoing MLKR between February 2018 and July 2021. Forty patients had full outcome assessment postoperatively at 6, 12 and 24 months and were included in the analysis, 75% were knee dislocation one injuries and 60% were injured playing sport. Patient-reported outcome measures (PROMs) assessed included the International Knee Documentation Committee score, the Knee Outcome Survey, the Lysholm Knee Score and the Tegner Activity Scale (TAS). Patient satisfaction was also assessed. Objective assessment included assessment of active knee flexion and extension range of motion (ROM), the single (single horizontal hop for distance [SHD]) and triple (triple horizontal hop for distance [THD]) hop tests for distance and peak isokinetic knee flexor/extensor torque. 

Results 

All PROMs significantly improved (p < 0.001) from presurgery to 24 months postsurgery. At 24 months, 70% of patients were satisfied with their sports participation. Active knee flexion (p < 0.0001) and extension (p < 0.0001) ROM significantly improved over time, as did the limb symmetry indices (LSIs) for the SHD (p < 0.0001), THD (p < 0.0001), peak knee extensor (p < 0.0001) and flexor (p = 0.012) torque. While LSIs for the SHD, THD and knee flexor strength tended to plateau by 12 months, knee extensor strength continued to improve from 12 to 24 months. 

Conclusions

The majority of patients undergoing modern MLKR surgical techniques and rehabilitation can achieve excellent knee function, with low complication rates. 

Level of Evidence 

Level IV.

Original languageEnglish
Pages (from-to)2967-2977
Number of pages11
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume32
Issue number11
Early online date4 Jul 2024
DOIs
Publication statusPublished - Nov 2024

Keywords

  • clinical outcomes
  • knee dislocation
  • multiligament knee injury
  • multiligament knee reconstruction

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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