Multi-ligament Injuries

Ligaments are the fibrous tissue bands connecting the bones in the joint and stabilizing the joint. The knee has four major ligaments – the anterior cruciate ligament, posterior cruciate ligament, lateral collateral ligament, and medial collateral ligament. There is also a “fifth ligament” of the knee which is the posterior lateral corner, which is a complex of multiple small ligaments and muscles.

A multi-ligament knee injury involves injury to two or more ligaments of the knee. These injuries are usually high energy in nature – meaning motor vehicle accidents are most common, but we do see these types of injuries in skiing and football injuries at the higher levels. The injury could indicate a knee dislocation that can cause injuries to the nerves and blood vessels requiring specialized care.

A knee with multiple ligaments damaged requires special care. Some of these ligaments can be repaired if they are addressed early enough – within 3 weeks. This is especially crucial for the posterior lateral corner which is often misdiagnosed or neglected with bad results. A multi-ligament knee will often require serial surgeries for repair of certain structures and then reconstruction of other ligaments.