Diagnosis and treatment strategies of the multiligament injured knee: a scoping review

Abstract

ObjectiveTo map the current literature evaluating the diagnosis and treatment of multiligament knee injuries (MLKIs).DesignScoping review.Data sourcesPreferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and Arksey and O’Malley frameworks were followed. A three-step search strategy identified relevant published literature comprising studies reporting on at least one aspect in the diagnosis or treatment of MLKI in adults. Data were synthesised to form a descriptive analysis and thematic summary.ResultsOverall, 417 studies were included. There was a substantial chronological increase in the number of studies published per year, with 70% published in the last 12 years. Of included studies, 128 (31%) were narrative reviews, editorials or technical notes with no original data. The majority of studies (n=239, 57%) originated from the USA; only 4 studies (1%) were of level I evidence. Consistent themes of contention included clinical assessment, imaging, operative strategy, timing of surgery and rehabilitation. There was a lack of gender and ethnic diversity reported within patient groups.ConclusionsThere remains insufficient high-level evidence to support definitive management strategies for MLKI. There is considerable heterogeneity in outcome reporting in current MLKI literature, precluding robust comparison, interpretation and pooling of data. Further research priorities include the development of expert consensus relating to the investigation, surgical management and rehabilitation of MLKI. There is a need for minimum reporting standards for clinical studies evaluating MLKI.

Ultrasound With Stress for Assessing Injuries to the Medial and Lateral Collateral Ligaments of the Knee

“…A recent systematic review evaluated reference radiographic measurements for stress radiography in diagnosing knee ligament injuries, highlighting its accuracy and reproducibility despite methodologic heterogeneity among studies. 13 In addition, other studies emphasize stress radiography’s role in precisely assessing instability in multiligament knee injuries 14 , 15 and its advantage in comparing with the healthy contralateral side, reinforcing its diagnostic value. 5 , 15…”

Do Age and Timing Influence the Outcomes of Single‐stage Reconstruction of Multiple Ligament Knee Injuries? 5‐10 Years Follow Up

“…M ultiple ligament knee injuries (MLKIs) have long been a formidable challenge, garnering attention due to their intricacy and diversity. [1][2][3] Such injuries typically involve damage to multiple ligaments within the knee, including the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), lateral collateral ligament (LCL), or posterolateral corner (PLC), making diagnosis and treatment a challenging endeavor. 4,5 Surgical reconstruction of ruptured multi-ligaments has become a preferred treatment option for most MLKIs.…”