Comprehensive Arthroscopic Management of Multi-ligament Knee Injury: A Case Report.

Abstract

Introduction: Multi-ligament knee injuries (MLKIs), involving damage to two or more major knee ligaments, present complex challenges in orthopedic surgery due to the intricacy of the injury and its significant impact on knee stability and function. These injuries often require specialized treatment strategies, with two-stage surgical reconstructions emerging as a viable option. This report examines a case of MLKI and the outcomes of a staged surgical approach to repair and reconstruct the affected knee ligaments.

Case report: A 55-year-old female sustained a multi-ligament injury to her right knee after a twisting event, resulting in pain, swelling, and instability. The patient underwent a two-stage arthroscopic reconstruction, beginning with repair of the posterior cruciate ligament and posterolateral corner structures, followed by anterior cruciate ligament reconstruction. Autografts, including the bilateral peroneus longus and contralateral hamstrings, were used for the procedure. Her rehabilitation protocol emphasized early passive range of motion exercises, with delayed weight-bearing to promote effective healing.

Conclusion: This case demonstrates the successful restoration of knee stability and function following a two-stage surgical approach to MLKI. The case underscores the need for individualized treatment plans and highlights the potential benefits of a phased procedure. While promising, further research is required to compare single-stage and two-stage approaches and to assess their long-term outcomes in managing complex MLKIs.