Surgical Treatment of Combined Anterior Cruciate Ligament and Lateral-Side Injures: Acute and Chronic

Vogel, Laura A.; Edgar, Cory; Arciero, Robert A.

doi:10.1007/978-3-030-05396-3_11

Cited by 3 publications

(2 citation statements)

References 102 publications

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“…After osteotomy as a first stage, we should assess whether ligament reconstruction is necessary in a second stage. 9 Table 3 summarizes the grafts and techniques used in MLKI. 3 …”

Section: Reconstruction Of Multiligament Knee Injuriesmentioning

confidence: 99%

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

et al. 2021

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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

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“…After osteotomy as a first stage, we should assess whether ligament reconstruction is necessary in a second stage. 9 Table 3 summarizes the grafts and techniques used in MLKI. 3 …”

Section: Reconstruction Of Multiligament Knee Injuriesmentioning

confidence: 99%

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

et al. 2021

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“… 11 One of the possible explanations may be that MRL is being diagnosed more on MRI scan when chronic ACL injury is present because the tissues are not as firmly attached, it becomes easier to differentiate between the structures and identify the abnormality. 34 …”

Section: Pre-operative Evaluationmentioning

confidence: 99%

Ramp lesion of the medial meniscus

et al. 2021

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Ramp lesion of the medial meniscus used to be completely disregarded in the past. Ramp lesion has been now put under the spotlight by orthopaedic and sport medicine surgeons and requires attention. It is closely associated with anterior cruciate ligament injury. Major risk factors include chronic laxity, lateral meniscal lesion, anterior cruciate ligament reconstruction revision, anterolateral ligament tear concomitant with anterior cruciate ligament injury, time from injury, pre-operative side-to-side laxity > 6 mm, age < 30 years old, male sex, etc. Radiologists attempt to create diagnostic criteria for ramp lesion using magnetic resonance imaging. However, the only definite method to diagnose ramp lesion is still arthroscopy. Various techniques exist, among which posteromedial approach is the most highly recommended. Various treatment options are available. The success rate of ramp repair is very high. Major complications are uncommon. Cite this article: EFORT Open Rev 2021;6:372-379. DOI: 10.1302/2058-5241.6.200126

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Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation

Murray,

Makaram,

Geeslin

et al. 2024

Br J Sports Med

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Multiligament knee injuries (MLKIs) represent a broad spectrum of pathology with potentially devastating consequences. Currently, disagreement in the terminology, diagnosis and treatment of these injuries limits clinical care and research. This study aimed to develop consensus on the nomenclature, diagnosis, treatment and rehabilitation strategies for patients with MLKI, while identifying important research priorities for further study. An international consensus process was conducted using validated Delphi methodology in line with British Journal of Sports Medicine guidelines. A multidisciplinary panel of 39 members from 14 countries, completed 3 rounds of online surveys exploring aspects of nomenclature, diagnosis, treatment, rehabilitation and future research priorities. Levels of agreement (LoA) with each statement were rated anonymously on a 5-point Likert scale, with experts encouraged to suggest modifications or additional statements. LoA for consensus in the final round were defined ‘a priori’ if >75% of respondents agreed and fewer than 10% disagreed, and dissenting viewpoints were recorded and discussed. After three Delphi rounds, 50 items (92.6%) reached consensus. Key statements that reached consensus within nomenclature included a clear definition for MLKI (LoA 97.4%) and the need for an updated MLKI classification system that classifies injury mechanism, extent of non-ligamentous structures injured and the presence or absence of dislocation. Within diagnosis, consensus was reached that there should be a low threshold for assessment with CT angiography for MLKI within a high-energy context and for certain injury patterns including bicruciate and PLC injuries (LoA 89.7%). The value of stress radiography or intraoperative fluoroscopy also reached consensus (LoA 89.7%). Within treatment, it was generally agreed that existing literature generally favours operative management of MLKI, particularly for young patients (LoA 100%), and that single-stage surgery should be performed whenever possible (LoA 92.3%). This consensus statement will facilitate clinical communication in MLKI, the care of these patients and future research within MLKI.

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Surgical Treatment of Combined Anterior Cruciate Ligament and Lateral-Side Injures: Acute and Chronic

Cited by 3 publications

References 102 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

Ramp lesion of the medial meniscus

Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation

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