Multi-ligament Knee Reconstruction Surgery
Comprehensive Surgical Repair to Restore Stability After Complex Knee Ligament Injuries
Knee injuries can sometimes involve damage to more than one ligament, particularly in high-impact situations such as sports collisions or motor vehicle accidents. These severe injuries, known as multi-ligament knee injuries, require careful management due to the complex nature of the damage. Multi-ligament injuries can significantly compromise knee stability, affecting your ability to walk, run, and perform even basic movements. In most cases, surgical intervention is necessary to achieve the best possible recovery.
Multi-ligament knee reconstruction procedures are designed to address the extensive damage, by repairing or reconstructing each affected ligament. Dr Liddell specialises in these complex reconstructions, aiming to restore stability and help patients regain confidence in their knee.
WHAT IS A MULTI-LIGAMENT KNEE INJURY?
The four major ligaments typically affected in multi-ligament knee injuries include:
- Anterior Cruciate Ligament (ACL): Located in the centre of the knee, the ACL is crucial for stabilising forward and rotational movements.
- Medial Collateral Ligament (MCL): Positioned along the inner side of the knee, the MCL often sustains injury when the knee buckles inward.
- Posterior Cruciate Ligament (PCL): Situated behind the knee, the PCL prevents the shinbone (tibia) from moving backward relative to the thigh bone (femur). PCL injuries commonly occur from direct impact on the shin, such as a fall. Isolated PCL injuries may heal with conservative treatment, though extended bracing is often required.
- Lateral Collateral Ligament (LCL): Located on the outer side of the knee, the LCL stabilises lateral movement. Injuries to the LCL and other ligaments in the knee’s posterior and lateral regions often result in chronic instability and frequently require surgical repair, as they do not typically heal well on their own.
A multi-ligament knee injury involves tearing two or more of these ligaments, and surgery is usually essential to restore stability and function. These injuries are complex and often result from high-impact trauma, such as sports injuries, motor vehicle accidents, or severe falls. Multi-ligament injuries can cause significant pain, instability, and functional impairment, severely affecting a person’s ability to walk, bear weight, or participate in physical activities.
MULTI-LIGAMENT KNEE RECONSTRUCTION SURGERY
Multi-ligament knee reconstruction involves repairing or reconstructing the damaged ligaments to restore stability and function to the knee. It is a complex procedure that typically involves arthroscopic and open surgical techniques to access and repair each damaged ligament.
Here’s What to Expect During the Procedure:
- Anaesthesia: You will receive general anaesthesia (which puts you to sleep) or spinal anaesthesia (which numbs you from the waist down) to ensure comfort throughout the procedure.
- Arthroscopic and Open Surgery: Dr Liddell will make small incisions around the knee to insert an arthroscope, a slender tube with a camera, allowing for a clear view of the knee’s interior on a monitor. For certain ligaments, larger incisions may be needed to directly access and repair the damaged tissue.
Ligament Reconstruction:
- ACL and PCL Reconstruction: If the ACL or PCL is damaged, Dr Liddell may reconstruct these ligaments using a graft, either from your own tissue (autograft) or a donor (allograft).
- MCL and LCL Repair: For the MCL and LCL, direct repair or reinforcement with grafts may be performed, depending on the extent and location of the damage.
- Graft Placement and Fixation: Once the grafts are in place, Dr Liddell will use specialised tools to secure them to the bone, allowing them to act as replacement ligaments. The grafts are fixed at precise angles to replicate the natural function of the ligaments and support stable knee movement.
- Completion: After all ligaments are repaired or reconstructed, the instruments are removed, and the incisions are closed with sutures or adhesive strips. The knee is bandaged, and you will be taken to a recovery area for monitoring.
RECOVERY AFTER MULTI-LIGAMENT KNEE RECONSTRUCTION
Recovering from multi-ligament knee reconstruction requires a structured rehabilitation plan, with a focus on protecting the knee, regaining strength, and restoring function.
First Few Weeks
- Immobilisation: You may need to wear a knee brace to protect the repaired ligaments and limit movement. Crutches are often used to keep weight off the knee.
- Pain Management: Pain and swelling can be managed with prescribed medications, ice therapy, and elevation of the leg.
- Early Physiotherapy: Initial exercises will focus on maintaining joint mobility and preventing stiffness. Range-of-motion exercises are introduced carefully to avoid stressing the newly reconstructed ligaments.
6 to 12 Weeks
- Strengthening Exercises: Gradual strengthening exercises for the quadriceps, hamstrings, and calf muscles are introduced to restore stability to the knee.
- Increased Weight-Bearing: You may begin to put more weight on the knee as tolerated, under guidance from Dr Liddell and your physiotherapist.
3 to 6 Months
- Advanced Rehabilitation: During this period, more intensive physiotherapy is introduced to improve knee function, balance, and flexibility.
- Return to Low-Impact Activities: By around six months, many patients are able to return to light activities, though high-impact sports should still be avoided.
6 to 12 Months and Beyond
- Gradual Return to Sport: Dr Liddell will advise on the safest time to resume sports or high-impact activities. Full recovery from multi-ligament knee reconstruction can take 9 to 12 months, with ongoing physiotherapy to achieve optimal stability and strength.
LONG-TERM OUTLOOK AFTER MULTI-LIGAMENT KNEE RECONSTRUCTION
While multi-ligament knee reconstruction is a complex procedure, it has a high success rate for restoring knee stability and function. Some patients may need to make long-term adjustments to avoid high-impact sports or activities that could place excessive stress on the knee. Regular follow-up appointments and continued strengthening exercises can support long-term joint health, reduce the risk of re-injury, and help maintain knee stability over time.
Dr Liddell and his team are committed to supporting you throughout the recovery process, ensuring that you have the guidance and care needed to regain confidence in your knee and return to an active lifestyle.