What is a Multiligamentous knee injury?
The knee has many structures that help stabilize the knee. These are mainly different types of collateral ligaments and cruciate ligaments (ACL, PCL, LCL, and MCL). Each one of these ligaments has a specific role in keeping the knee stable. The most commonly injured knee ligament is the ACL or anterior cruciate ligament. However, the other ligaments can be injured at the same time causing a combined knee injury.
Mechanism of Injury?
A combined knee injury often occurs due to a twisting event of the knee or when another player lands on the knee. This is common in sports like football, soccer, wrestling and basketball. Other high energy injuries, such as a fall from a high area or a motor vehicle crash, can result in serious damage to a knee as well. When two or more ligaments are damaged, this can lead to other injuries to nerves and vascular structures.
Diagnosis and Symptoms of a Combined Knee Injury
Commonly, after a major injury to the knee, the person may experience a popping sound, have significant pain in the knee, difficulty putting weight on the knee to walk, and decreased motion of the knee. This commonly follows with swelling and bruising over time. It is important to be evaluated by a qualified physician before resuming normal activities. These injuries can be diagnosed with a physical exam and commonly requires X-rays and possibly advanced imaging with a MRI to determine the full extent of the injury.
Treatment of Multiligamentous Knee Injury
Initially, the athlete should stop playing their sport to not cause any more damage to the knee before being examined. Braces, like a knee immobilizer, and crutches are often required as the initial first treatment. Rest, ice, elevation and anti-inflammatories should be started right away.
Treatment for a combined ligament tear will depend on each individual’s needs as well as the severity of the injury. Surgical and non-surgical options do exist depending on the type of activities you are involved in and the type of lifestyle you live. This can involve non-operative treatment with physical therapy, targeted exercises to regain range of motion and quadricep strength, and gradual return back to an exercise program. Some individuals will require surgical management to restore their knee function.
For more information, please consider the following link that was produced by the AAOS.
https://orthoinfo.aaos.org/en/diseases–conditions/combined-knee-ligament-injuries