Multi-Ligament Knee Injuries

What are multi-ligament knee injuries?

The knee joint is home to four elastic bands of tissue (ligaments) that connect bones and provide joint stability. The middle of the knee joint houses the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). Together, these ligaments form an “X” and work collectively to limit forward and backward movement of the tibia (shin bone) in relation to the femur (thigh bone). The medial collateral ligament (MCL) and lateral collateral ligament (LCL) are located on the sides of the knee joint and are responsible for preventing side-to-side joint movement. Multi-ligament injuries are particularly rare events in which two or more ligaments are damaged in the same traumatic incident. These injuries often result from events such as a rough tackle in football, a fall from several feet, or a high-speed motor vehicle collision. Dr. Joseph D. Lamplot, orthopedic knee specialist serving patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, has the knowledge and understanding, as well as substantial experience, in treating patients with multi-ligament knee injuries.

What are the symptoms of multi-ligament knee injuries?

While each knee ligament has a distinct mechanism for limiting knee joint movement, all four ligaments work collaboratively to protect the knee joint as a whole. Because each ligament has a separate role in stabilizing the knee joint, it is strongly encouraged to consult an orthopedic knee specialist for an accurate diagnosis. The most common symptom of multi-ligament knee injuries reported among individuals is moderate to severe knee pain and instability. This pain typically occurs immediately following a traumatic event and may not be localized to one area of the knee joint. Damage to knee ligaments often weakens their ability to stabilize the knee joint; therefore, knee joint instability of varying degrees is common with multi-ligament knee injuries. Individuals also often report knee joint swelling and decreased range of motion.

How are multi-ligament knee injuries diagnosed?

To accurately diagnose multi-ligament knee injuries, Dr. Lamplot will gather a comprehensive medical history and perform an extensive physical examination with a focus on the affected knee joint. Diagnostic imaging studies are especially beneficial in confirming multi-ligament knee injuries. X-rays identify any bone-related injuries, such as dislocation or fracture, while magnetic resonance imaging (MRI) analyzes the soft-tissue structures to pinpoint the areas of tissue damage and determine injury severity.

What is the treatment for multi-ligament knee injuries?

If multi-ligament knee injuries are suspected, it is essential to consult an orthopedic knee specialist in a timely manner, as both non-surgical and surgical therapies are time-sensitive.

Non-surgical treatment:

When only minimal ligament damage is sustained, non-surgical therapies are often the initial course of treatment. Symptoms associated with low-grade multi-ligament knee injuries, particularly pain and inflammation, can be controlled with a combination of RICE (rest, ice, compression, elevation) and non-steroidal anti-inflammatory medications (NSAIDs). When it is considered safe, Dr. Lamplot may prescribe an individualized physical rehabilitation program to strengthen and stabilize the knee joint. Bracing may also be appropriate. However, most multi-ligament knee injuries, especially those with complete ligament tears, are not successfully treated conservatively.

Surgical treatment:

Surgical intervention is most often the recommended treatment option for multi-ligament knee injuries. Surgical repair or reconstruction of the knee ligaments should occur as soon after the injury as possible to prevent scar tissue formation and improve the functional outcomes after surgery. Multi-ligament knee reconstruction is a highly individualized procedure as it is tailored to the patient’s specific injuries as well as the complexity of these injuries. Tendon grafts are harvested from either the patient (autograft) or donor (allograft) to replace the injured portions of the native knee ligaments. Multi-ligament knee reconstruction may be performed using a combination of various open and arthroscopic surgical techniques to complete the necessary repairs for multi-ligament knee injuries.

Complex Knee Specialist