Knee

Complex Multiligament Knee Injuries

Multiligament knee injuries are also known as knee dislocations and occur when the end of the femur [thigh bone] separates from the tibia [shin bone], causing multiple knee ligaments to tear. These injuries are very severe and lead to gross instability of the knee. Surgery is usually required to reconstruct the ligaments. This surgery is often extensive and technically demanding.

• How it happens

  Multiligament knee trauma is frequently the result of a high energy injury such as a car accident or fall from a height. It can also occur from a sports injury, or rarely, a fall at work or during everyday activity. In these injuries, two or more of the major ligaments in the knee are severely injured and require surgery. If three or all four of the major ligaments are injured, the knee may be dislocated.

• How it feels

  These injuries are usually associated with severe pain and swelling of the knee. Patients can generally not walk and in some cases have damage to the nerves or arteries of the leg. Because many ligaments in the knee are injured, the knee is normally unstable after a period of healing. The patient will feel unstable on their knee and it can feel loose and wobbly.

• How it is fixed

  In some cases, one or more of the ligaments may heal without surgery. In most patients, surgery is required to reconstruct ligaments. Repair may be performed where the ligaments are stitched back together, but frequently the ligaments must be constructed using a graft to make a new ligament. The graft may be taken from the patient, or frequently donor tissue (allograft) is used since many grafts are required for the procedure.

• Recovery/Post-Surgery

  After multiligament knee reconstruction, patients are in a brace and do not bear weight on the knee for approximately four weeks, depending on the procedure. Physical therapy is required and crutches are generally used for over one month.

Testimonials

"Two years ago, I was the starting varsity midfielder for my high school soccer team, star javelin thrower for track, and was in the best shape of my life. My plan was to attend a Division 1 college and fulfill my dream of playing soccer there. This all changed when I tore my left ACL in the state cup final of my club soccer teams game. I was dribbling beside a girl, and tore it with an effortless cut. It was my sophomore year of high school and I would have to miss my junior year of soccer and the rest of my spring season as well. Although I was completely destroyed by it, I was determined to get back to my full potential. I had an ACL tear, meniscal tear, as well as a microfracture in which another doctor insisted on drilling holes into my bone to heal it."

"I trained for a whole year and was finally cleared to return to playing. One day later, while training with the javelin, I planted with my left leg, and it completely gave out on me, tearing again. My mother researched for days and took me to eight different doctors this time, determined to find the best. Every doctor seemed the same to me; didn't seem to actually care. It was as if I was just another number."

"On the last visit, we took the trip up to Hospital for Special Surgery. When I finally met Dr. Marx, it occurred to me that he was the only doctor out of the eight who actually seemed to care. He was entirely sympathetic and actually showed emotion in what he does. Dr. Marx realized my lateral knee ligament had been loose, which had led to the second tear. Out of the eight doctors we visited, he was the only one to notice that. He reconstructed my ACL as well as my LCL. While in the hospital, I had stayed two nights. A week later while resting on my couch, I received a phone call from Dr. Marx just to see how I was doing and feeling. To have a personal call from the doctor himself really ensured me that I had been in good hands."

"After yet another difficult year of rehab and training, I decided I would return to the sport I loved. I ended up still throwing javelin at my high school and earned 1st place in my division. I am currently a freshman at Philadelphia University, and in the Physician Assistant Program as well. I am also playing Division 2 soccer here on the Women's team and am loving every minute of it. I haven't had any problems with my knee and it's never felt more secure, stronger, or safer before this. I owe all my gratitude towards Dr. Marx and Hospital for Special Surgery, not only for my recovery, but for giving me a direction on where I want to go with my life. After becoming a physician assistant, my dream is to hopefully work at HSS, live in New York, and help young athletes like Dr. Marx did for me. "

~ Lauren Mirabelli