Abstract
Multiligament knee injuries (MLKI) are complex and challenging to treat. The posteromedial
corner (PMC) structures are commonly torn in MLKI. A thorough and systematic evaluation
is imperative to avoid a missed diagnosis and for planning treatment. With several
structures injured, the treatment method (operative vs. nonoperative, repair vs. reconstruction),
availability of allografts, timing of surgery, and rehabilitation are some of the
factors that have to be considered in the decision-making. Persistent valgus instability
because of untreated or not healed medial collateral ligament (MCL) tears will increase
graft forces on the cruciate ligament grafts, thus increasing the risk of reconstruction
graft failure. In recent years, there has been a growing body of literature on the
anatomy and biomechanics of the medial structures that has aided in the development
of biomechanically and clinically validated anatomic PMC reconstructions. Despite
good healing potential of the MCL, in MLKI, surgical treatment is recommended for
grade III PMC injuries to aid early rehabilitation and reduce the risk of surgical
failure. Several studies have reported satisfactory outcomes after surgical treatment
of MLKI involving the medial side. Early functional rehabilitation is imperative to
reduce the risk of arthrofibrosis.
Keywords
multiligament knee injuries - medial collateral ligament - posteromedial corner -
knee dislocation - knee ligament
