Ann Med Med Res | Volume 6, Issue 1 | Case Report | Open Access

Controversies on Management of Multi-Ligament Injury of Knee: A Case Report and Review on Current Concepts

Anil R*, Bishwa BN, Aditya KS, Satish K, Chaubey SP and Pradeep KM

Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, India

*Correspondance to: Anil Regmi 

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Background: Multi-ligamentous injury of the knee is a common condition, but difficult to deal with due to their complexity and heterogeneity of ligamentous structures inside knee. Systematic approach for diagnosis and treatment is required to achieve an adequate range of motion. Objective: This paper presents the management of multi-ligamentous knee injury with reconstruction and discusses the controversial topic with suggested literature for management options such as conservative or operative, repair or reconstruction, the timing of surgery, graft selection, and rehabilitation protocol, as well as the proposed literature. Case Report: A 22-year-old female with multi-ligamentous injury of the knee (ACL + PCL + MCL) managed with arthroscopic ACL + PCL reconstruction and open MCL repair after two month of injury, and gradual mobilization started in postoperative phase has a Lyshlom score of knees was 88, and a Tegner Activity Score was 7 at one year of follow-up. Discussion and Conclusion: Early and Operative management is superior compared with nonoperative or delayed management. There was a higher rate of inability to return to pre-injury level activity level, flexion loss and posterior sag with repair, although no significant difference exists between reconstruction and repair. Peroneus longus tendon graft has a better functional outcome than the hamstring tendon autograft, but the choice of graft depends on patients’ and surgeons’ preferences, as well as the number and availability of grafts. In a postoperative rehabilitation, early mobilization help to reduce arthrofibrosis.


Multi-ligamentous injury; ACL reconstruction; PCL reconstruction; Lyshlom score; Level V


Anil R, Bishwa BN, Aditya KS, Satish K, Chaubey SP, Pradeep KM. Controversies on Management of Multi- Ligament Injury of Knee: A Case Report and Review on Current Concepts. Ann Med Medical Res. 2023; 6: 1059..

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