Revision Multiligament Knee Reconstruction Surgery

Stuart, Michael; Woodmass, Jarret M.; Krych, Aaron J.; Levy, Bruce A.; Stuart, Michael J.

doi:10.1055/s-0039-3402791

Cited by 4 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This laxity is frequently associated with other problems: limb malalignment, meniscus deficiency, articular cartilage insufficiency, reduced motion, compromised bone stock, and a paucity of graft sources. 35 The indication and surgical technique to be performed during revision surgery require a thorough evaluation of each patient and their injury and treatment factors. It also requires a good physical examination and advanced imaging tests.…”

Section: Revision Surgerymentioning

confidence: 99%

Complications of surgical reconstruction of multiligament injuries of the knee joint: diagnosis, prevention and treatment

et al. 2021

View full text Add to dashboard Cite

The main complications of surgical reconstruction of multiligament injuries of the knee joint are residual or recurrent instability, arthrofibrosis, popliteal artery injury, common peroneal nerve injury, compartment syndrome, fluid extravasation, symptomatic heterotopic ossification, wound problems and infection, deep venous thrombosis, and revision surgery. Careful surgical planning and execution of the primary surgical reconstruction of multiligament injuries of the knee joint can minimize the risk of the aforementioned complications. Careful postoperative follow-up is required to detect complications. Early recognition and prompt treatment are of paramount importance. To obtain good results in the revision surgery of failed multiligamentary knee reconstructions, it is crucial to perform a thorough and exhaustive evaluation to detect all the causes of failure. Addressing all associated injuries during revision surgery will lead to the best possible subjective and objective results, although functional outcomes are often modest. However, advanced age and high-energy injuries have been associated with the poorest functional outcomes after revision surgery of failed multiligament injuries of the knee joint. Cite this article: EFORT Open Rev 2021;6:973-981. DOI: 10.1302/2058-5241.6.210057

show abstract

Section: Revision Surgerymentioning

confidence: 99%

Complications of surgical reconstruction of multiligament injuries of the knee joint: diagnosis, prevention and treatment

et al. 2021

View full text Add to dashboard Cite

show abstract

“…31 Revision multiligament knee reconstruction is challenging due to recurrent pathologic laxity that is often associated with limb malalignment, bone tunnel enlargement, retained hardware, meniscus and cartilage defects, and so on. 32,33 In the revision cases, lack of graft sources may be one of the severe problems, including allocation of grafts or surgical procedures. From these findings, it is desirable to sacrifice autogenous grafts for primary MLKI surgery as little as possible.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Remnant-Preserved Single-Bundle Anterior Cruciate Ligament Augmentation in Multi-ligamentous Knee Reconstruction

et al. 2022

View full text Add to dashboard Cite

This study was conducted to present remnant-preserving anterior cruciate ligament (ACL) augmentation as a useful option for partial ACL injury in multiligament knee injury (MLKI) cases, which may also contribute to conserving graft resources. The present study involved patients diagnosed with MLKI at our institute from Spring 2006 to February 2021. A total of 71 MLKI cases were provided surgery due to knee instability and disability. For every patient, an arthroscopic diagnostic was performed to ensure that ACL tear and a remnant were present. When the ACL remnant was classified into group 2, 3, or 4 of Nakamae's classification, remnant-preserved single bundle ACL augmentation was performed. Graft selection and the combination of injured ligaments were evaluated. The side-to-side difference under an anterior tibial load of 134 N with an arthrometer and the leg symmetry index at 60 degrees/s were measured. The present procedure was performed for five cases (male/female: 4/1, mean age: 33.6 years). The mean follow-up period was 26.4 months. The combination of torn ligaments was as follows: 3 cases of ACL + medial collateral ligament, one case of ACL + posterior cruciate ligament, and one case of ACL + posterolateral corner. An ACL augmentation graft was performed using an ipsilateral gracilis tendon in 2 cases, a contralateral full semitendinosus tendon in 2 cases, and the ipsilateral distal 1/2 of the semitendinosus tendon in 1 case. The mean side-to-side difference was 1.07 ± 0.4 mm. The mean leg symmetry index was 82.6 ± 12.2% in knee extension and 96.3 ± 9.9% in knee flexion. Although the present study was a small case series, the remnant-preserved single-bundle ACL augmentation for MLKI surgery provided good clinical outcome and conserved the graft resource. Even in the MLKI case, this technique is one of the useful surgical options. The level of evidence of this study is level IV (case series).

show abstract

“…35 The importance of a systematic and biomechanically and clinically validated approach to multiligament knee reconstruction cannot be understated; revision multiligament procedures frequently must contend with extensive scarring and osteolysis, loss of autograft because of previous harvest, arthrofibrosis, and a significant quantity of retained hardware. 36 Appropriate graft tensioning sequence is important to avoid overconstraint of the joint. If the ACL is tensioned first, posterior displacement of the tibia may result, whereas early PLC graft tensioning may result in increased internal tibial rotation.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multiple Ligament Reconstructions of the Knee and Posterolateral Corner

Floyd

Carlson

Monson

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

Injuries to the knee involving multiple ligaments occur in a variety of circumstances and require careful assessment and planning. A wide constellation of injuries can occur with causes sufficiently traumatic to produce bicruciate ligament deficiency, and this technical report will describe diagnosis, treatment and rehabilitation for a knee dislocation with lateral injury (KD-III-L on the Schenk classification). Reconstruction in the acute setting is preferred, with anatomic-based, single-bundle anterior cruciate ligament reconstruction, double-bundle posterior cruciate ligament reconstruction, and anatomic reconstruction of the posterolateral corner using two grafts for the 3 primary posterolateral corner stabilizers. Tunnel orientation to prevent convergence and sequence of graft tensioning and fixation are discussed as well. Successful outcomes have been achieved using these anatomic-based reconstruction techniques along with appropriate rehabilitation and bracing.

show abstract

Revision Multiligament Knee Reconstruction Surgery

Cited by 4 publications

References 29 publications

Complications of surgical reconstruction of multiligament injuries of the knee joint: diagnosis, prevention and treatment

Complications of surgical reconstruction of multiligament injuries of the knee joint: diagnosis, prevention and treatment

Remnant-Preserved Single-Bundle Anterior Cruciate Ligament Augmentation in Multi-ligamentous Knee Reconstruction

Multiple Ligament Reconstructions of the Knee and Posterolateral Corner

Contact Info

Product

Resources

About