Multiligament Knee Injury

Multiligament knee injuries often result from high-energy trauma, such as motor vehicle accidents, sports injuries, or significant falls, that lead to substantial knee instability and dysfunction. Typically, there is a twisting or pivoting injury to the knee or a direct blow to the knee. Athletes who participate in high-impact and contact sports like football, basketball, and skiing are at a higher risk of multi-ligament knee injuries.

Patients with multi-ligament knee injuries often present with severe knee pain, significant swelling, limited motion of the knee, and difficulty walking. They may also have signs of nerve damage and blood vessel injury.

A comprehensive clinical assessment is essential to determine the extent of the ligament injuries and to determine whether there are other injuries to the cartilage, meniscus, nerves, and blood vessels. Our UCSF Sports Medicine physician will review how your injury occurred and perform a comprehensive physical examination to assess ligament integrity, evaluate for damage to the nerves or blood vessels, and identify any associated injuries.

X-rays are necessary to rule out fractures and assess the alignment of the knee joint. MRI is crucial for evaluating the extent of soft tissue injuries, including damage to ligaments, menisci, cartilage, and bone. Additional imaging may be necessary, such as a CT scan or ultrasound, to evaluate the nerves and blood vessels surrounding the knee.

Managing multiligament knee injuries is complex and individualized, depending on the injury. Treatment may be conservative or surgical, depending on the severity of the injury, the specific ligaments involved, and the patient’s individual activity level and goals.

• Conservative treatment includes a period of rest, medications for pain, bracing, and physical therapy. This treatment plan may be appropriate for patients with less severe injuries, those participating in lower-level activities, or if surgery is deemed too high risk. The goal is to reduce pain and inflammation and to improve knee function and stability.
• Surgical treatment aims to restore knee stability and function and may involve ligament repair or reconstruction. Depending on the specific injury and patient factors, surgery may be staged or performed in a single operation.

Recovery from a multi-ligamentous knee injury is a lengthy process, often taking one year or longer, depending on the injury severity. Postoperative rehabilitation is critical and includes working with a physical therapist on a range of motion exercises, strengthening, and gradually returning to functional activities. The goals are to restore knee function, strength, and stability while preventing complications such as stiffness and chronic pain. While surgical treatment can significantly improve outcomes, due to the severity of such injuries, some patients may experience some degree of functional limitation, such as stiffness, or develop osteoarthritis in the long term.

Multi ligament knee injuries are serious and require prompt evaluation and management to optimize outcomes. Their complexity necessitates a tailored, multidisciplinary approach to treatment and rehabilitation, focusing on restoring knee stability and function while minimizing long-term complications.