A Modern-Day Algorithm for the Treatment of Multi-Ligament Knee Injuries

IF 1.1 4区医学 Q3 ORTHOPEDICS Indian Journal of Orthopaedics Pub Date : 2024-09-14 DOI:10.1007/s43465-024-01252-x

Fidelius von Rehlingen-Prinz, Sebastian Rilk, Victor Beckers, Robert O’Brien, Gregory S. DiFelice

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Abstract

Introduction

Multiligament knee injuries (MLKI) are rare and complex, significantly impacting long-term outcomes, with risks of osteoarthritis, joint stiffness, and reduced activity levels.

Objective

To explore the evolution of MLKI treatment protocols, comparing historical and modern approaches, and to present a patient-tailored, preservation-first algorithm.

Methods

This article reviews the literature on MLKI management, focusing on surgical timing, techniques, and rehabilitation protocols. The proposed algorithm categorizes MLKIs based on tear location and tissue quality, incorporating options, such as primary ligament repair, augmentation, and reconstruction.

Results

The modern preservation-first algorithm provides a tailored approach to MLKI treatment, addressing the complexity and heterogeneity of these injuries, and aims to mitigate risks like postoperative arthrofibrosis.

Conclusion

MLKI management remains complex and controversial. The presented algorithm offers a structured, individualized treatment strategy that integrates modern surgical and rehabilitation advancements.

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治疗膝关节多韧带损伤的现代算法

导言膝关节多韧带损伤（MLKI）是一种罕见而复杂的损伤，对长期预后有重大影响，可能导致骨关节炎、关节僵硬和活动能力下降。方法本文回顾了有关 MLKI 治疗的文献，重点关注手术时机、技术和康复方案。结果现代的 "保护优先 "算法为 MLKI 治疗提供了一种量身定制的方法，解决了这些损伤的复杂性和异质性，旨在降低术后关节纤维化等风险。本文介绍的算法提供了一种结构化、个性化的治疗策略，融合了现代外科手术和康复治疗的进步。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Orthopaedics ORTHOPEDICS-

CiteScore

1.80

自引率

0.00%

发文量

185

审稿时长

9 months

期刊介绍： IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.