AANA Fellowship Education - Multiligament Injuries to the Knee-Multiligament Injuries to the Knee

Video Transcription

Video Summary

The Anna webinar series featured expert discussions on complex multi-ligament knee injuries, focusing on posterior cruciate ligament (PCL) reconstruction, medial, and lateral knee ligament management. Dr. Bruce Levy presented a preferred "all-inside" PCL reconstruction technique developed with Dr. Mike Stewart, highlighting its advantages in minimizing tunnel convergence and allowing precise graft tensioning. Long-term clinical outcomes showed excellent knee stability and function with this method. Dr. Brian Waterman emphasized challenges in managing medial knee injuries, advocating early surgical intervention for cases with persistent valgus instability or complex multiligament involvement. He differentiated repair, augmentation, and reconstruction approaches, stressing individualized treatment based on injury chronicity, healing potential, and patient demands. Dr. Rick Hatch discussed posterolateral corner (PLC) injuries, describing the anatomic LaPrade reconstruction technique and the importance of peroneal nerve identification. He introduced the use of suture tape augmentation ("internal brace") to reinforce repairs or reconstructions, facilitating earlier motion and weight-bearing, especially in polytrauma patients. Complex cases demonstrated the value of staged procedures, thorough intraoperative exams under anesthesia, stress fluoroscopy, and customized rehabilitation protocols. The panel agreed on critical principles: thorough preoperative planning; careful intraoperative assessment; recognition of capsular involvement; staged surgeries when needed with protection of the knee; cautious management of postoperative stiffness focusing on gradual progress; and close collaboration with mentors. They emphasized the importance of ANA membership for fellowship education and mentorship. The webinar underscored that multi-ligament knee injury treatment remains challenging, requiring expert evaluation, tailored surgical techniques, and coordinated postoperative care to optimize outcomes.

Asset Caption

Bruce A. Levy, M.D. | Gregory C. Fanelli, M.D. | George Rick Hatch III, M.D. | Brian R. Waterman, M.D.

Keywords

multi-ligament knee injuries

posterior cruciate ligament reconstruction

all-inside PCL technique

Dr. Bruce Levy

Dr. Mike Stewart

medial knee ligament management

valgus instability

repair augmentation reconstruction

posterolateral corner injuries

LaPrade reconstruction

suture tape augmentation

postoperative rehabilitation