AANA/ISAKOS Knee and Shoulder Arthroscopy Course-Online Didactics (April 2024)-Stress of the Multi Ligament Knee – Intra Op Pearls of Management to get you Through

Stress of the Multi Ligament Knee – Intra Op Pearls of Management to get you Through

Video Transcription

Video Summary

Dr. James Leonard, an orthopedic surgeon, discusses the complexities of multiligament knee injuries, which are rare and often involve various structures such as ACL, PCL, collateral ligaments, and sometimes neurovascular and bony injuries. Due to diverse injury patterns and low surgical volume, individualized treatment plans are essential, with surgical management generally favored for better outcomes. Preoperative evaluation includes radiographs, physical exams under anesthesia, stress radiographs, and MRI to thoroughly assess all damaged structures. Surgical timing is typically around three weeks post-injury to balance tissue healing and minimize stiffness, but acute or delayed interventions may be necessary. Dr. Leonard emphasizes detailed preoperative planning, graft selection (usually allografts), and a specific surgical sequence involving medial and lateral dissections, arthroscopy, and ligament reconstructions, prioritizing PCL tensioning first. Meticulous organization and intraoperative assessment optimize surgical success in these challenging cases, improving functional recovery and return to activity.

Keywords

multiligament knee injuries

orthopedic surgery

ACL and PCL reconstruction

preoperative evaluation

surgical timing

graft selection