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

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.