Course Lecture Pearls: Advanced Knee-Meniscus-Multiple Ligament Reconstructions_ When and How to Operate-Faculty Lecture

Multiple Ligament Reconstructions_ When and How to Operate-Faculty Lecture_ Darren L. Johnson, MD

Video Transcription

Video Summary

Dr. Darren Johnson discussed managing multiligament knee injuries, emphasizing diagnosis, timing, and surgical decision-making. Such injuries often involve both cruciate ligaments and one medial or lateral side, commonly from car or ATV accidents. Immediate reduction of dislocations and vascular evaluation within eight hours is critical to prevent amputation. Early surgery (within two weeks) is indicated for extensive medial damage, displaced meniscus, or Steiner lesions, prioritizing non-weight-bearing and controlled motion post-op. Surgical strategy involves arthroscopic work first, then open repair, favoring allografts over autografts due to complexity. Repair or reconstruction decisions depend on tissue quality. External fixators may be used in cases like morbid obesity. Stress x-rays and MRI are essential for preoperative planning. Dr. Johnson highlighted the importance of restoring stability while preserving motion, especially for athletes, and cautioned careful handling near neurovascular structures. Post-op rehab includes controlled range-of-motion machines and efficient operative technique to achieve optimal outcomes. The session concluded with advice on lab practice sequencing to maximize learning.

Keywords

multiligament knee injuries

surgical decision-making

early surgery indications

arthroscopic and open repair

postoperative rehabilitation