How Stable Do Multiligament Knee Reconstructions Become?: An Objective Stability and PROMs Study

Purpose of the Study

Multiligament injuries (MLKI) of the knee mainly result from high-velocity impacts. This study was done to analyse multilgament knee reconstructions done in a single setting at a minimum 12 month follow-up with objective gait, squat, stability and fluoroscopic examination along with PROMs and compare the individual KD categories. Also, the study analyses the difference between < 30- and > 30-year-olds as well as those who had sporting injuries versus RTAs.

Methodology

All cruciate ligaments were reconstructed arthroscopically. Collateral ligaments were reconstructed using autografts and fixed with interference screws. All were kept non-weight-bearing for 6 weeks on a brace. ROM exercises were begun at the earliest. Gait analysis, stability, balance, squat analysis and fluoroscopic analysis were used to determine the objective outcomes during follow-ups. PROMs were analysed pre- and postoperatively to document the functional activity of the patient. The analysis of the various parameters with objective measurements of the clinical, functional and patient-reported measures was done to assess the outcome in multiligament knee injury patients.

Results

ACL with MCL was the most common presenting multiligament-involved presentation, with KD3 being the most common pattern of injury. The parameters for contact time, step length, ROM at knee and hip on the normal and operated limbs were near normal and same at a minimum 1-year follow-up with a good stability index. The PROMs improved significantly postop. There was no difference in the results of sporting versus non-sporting injuries, those < 30 and > 30 years and between the individual KD groups.

Conclusion

The results showed statistically significant improvement in stability and PROMs at follow-up in multiligament reconstructions, but no difference comparing individual KD groups, < 30 and > 30 years age and those injured by RTA s and sporting injuries.