Modern Treatment Principles for Multiligament Knee Injuries.

Multiligament knee injuries are complex injuries that must be addressed with a comprehensive diagnostic workup and treatment plan. Multiligament injuries are commonly observed with concomitant meniscal, chondral, and neurovascular injuries, requiring a thorough clinical assessment and radiographic evaluation. Due to the higher failure rates associated with knee ligament repair following multiligament knee injury, the current literature favors single-stage anatomic knee reconstructions. Recent studies have also optimized graft sequencing and reconstruction tunnel orientation to prevent graft elongation and reduce the risk of tunnel convergence. In addition, anatomic-based ligament reconstruction techniques and the usage of suture anchors now allow for early postoperative knee motion without the risk of stretching out the graft. Rehabilitation following multiligament knee reconstruction should begin on postoperative day one and typically requires 9-12 months. The purpose of this article is to review the latest principles of the surgically relevant anatomy, biomechanics, evaluation, treatment, rehabilitation, and outcomes of multiligament knee injuries.