Complex Ligament Injuries?
What are Complex Ligament Injuries?
A complex ligament (or multi-ligament) knee injury means that more than one of the main knee ligaments has been damaged.
The anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) are the four primary knee ligaments (LCL).
The LCL includes many significant related structures that are grouped together as the postero-lateral corner.
A major accident or high-energy twisting injury is typically required for a patient to acquire a complicated ligament damage of the knee. In such cases both the treatment and rehabilitation can be difficult and prolonged.
What Are the Signs and Symptoms of a Complex Knee Ligament Injury?
– To injure more than one ligament, the knee must be displaced at the time of injury. Even if it promptly returns to its original position, ligament injury might occur.
– This means that injuries can present as obviously dislocated knees requiring immediate manipulation to simply restore the shape of the leg (and reduce pressure on important blood vessels). Alternatively, the damage may look small at first but be accompanied by growing discomfort and/or edema. It might take some time for a patient to seek care, generally when they realize their knee is unstable (as though it will give way).
– Pain is frequently more acute than with minor injuries, and the damage may occasionally include blood vessels feeding the lower leg (an emergency) or a crucial nerve (‘common peroneal’), resulting in temporary or permanent ‘foot drop.’
How Is Complex Knee Ligament Damage Diagnosed?
– For severe injuries, it is vital to get immediate medical attention from a knee expert since surgery is frequently necessary.
– This should ideally happen within 2-3 weeks for various injuries
– In order to plan therapy, a clinical examination will be paired with imaging (x-rays, MRI, and possibly further blood vessel studies).
How Are Complex Knee Ligament Injuries Treated?
Complex ligament injuries of the knee are quite rare and treatment is, by definition, more difficult. It usually involves multiple ligament reconstruction and a long period of rehabilitation.
When early surgery is necessary, it is usually performed after the swelling has subsided and is usually followed by a period of time with the knee in a brace and using crutches.
ACL/MCL injuries are perhaps the most frequent combination and are typically best treated by letting the MCL recover for a few weeks while the knee is supported in a hinged knee brace, followed by ACL reconstruction.
An osteotomy may be necessary to attempt to correct the alignment of the knee if there is substantial straining of the outer ligaments of the knee and patients seek care some time after the injury.
The outcome of surgery for complicated knee ligament damage is highly dependent on the exact injury pattern and is much less predictable than that of basic ACL replacement.
When these injuries are paired with nerve and/or blood vessel injury, the chances of returning to active sport are significantly reduced.