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Multiple Knee-Ligament Reconstructions
This section deals with knee dislocations, which are generally defined as traumatic injuries which involve at least three of the knee's four main ligaments. Please note that knee dislocations are very different from patellar dislocations (i.e. dislocated kneecap). Articles dealing with patellar problems can be found here.
See also PCL Injuries and Reconstructive Surgeries, Injuries and Surgeries pertaining to Posterolateral Structures (includes LCL), and Injuries Involving the MCL and Treatment Thereof, as well as ACL Reconstructions via Patellar Tendon Autografts, ACL Reconstructions via Hamstring Autografts, and ACL Reconstructions via Allografts.
For a brief overview of knee anatomy, physiology, and biomechanics, please click here.
For a comprehensive overview of all the major considerations pertaining to treatment of ACL injuries (including discussions of the impact of concomitant injuries, including damage to other ligaments as well as to articular cartilage and menisci), please see the October 2005 article Clinical Sports Medicine Update: Treatment of Anterior Cruciate Ligament Injuries, Part I, by Bruce D. Beynnon et al., in the ACL Reconstructions via Patellar-Tendon Autografts (includes also Quadriceps Tendon Autografts) Subsection. For insight into PCL reconstruction in knees harbouring multiple ligament injuries, please see the March 2003 article Anatomic Reconstruction of the Posterior Cruciate Ligament after Multiligament Knee Injuries: A Combination of the Tibial-Inlay and Two-Femoral-Tunnel Techniques, by James P. Stannard et al., in the PCL Injuries and Reconstructive Surgeries Subsection. Periarticular heterotopic ossification after multiple knee ligament reconstructions: A report of three cases, Christopher Patton; The American Journal of Sports Medicine, Baltimore; May/Jun 2000, Vol 28/3, p. 398. Comments: This article looks at the problems of unwanted lamellar-bone growth and arthrofibrosis in knees that have endured multiple traumas requiring more than one ligament reconstruction (and in which one of the reconstructed ligaments was the PCL). All three cases discussed herein were motor-vehicle-type traumatic incidents. The ghastly severity of automobile-related injuries only serves to underscore the fundamental physical principle that kinetic energy increases with the square of speed. For insight into the treatment of combined ACL-MCL tearing injuries, please see Anterior cruciate ligament-medial collateral ligament injury: Nonoperative management of medial collateral ligament tears with anterior cruciate ligament reconstruction: A preliminary report, by Shelbourne and Porter, and also The Treatment of Acute Combined Ruptures of the Anterior Cruciate and Medial Ligaments of the Knee, by Noyes and Barber-Westin, in the Injuries Involving the MCL and Treatment Thereof Subsection.
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