Multiligament Knee Injuries

What Are Multiligament Knee Injuries?

Multiligament knee injuries are severe injuries involving rupture of two or more stabilizing ligaments of the knee, including the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and the posterolateral corner (PLC).

These injuries cause significant knee instability and disruption of normal biomechanics. They usually occur after high-energy trauma, sports injuries, or road traffic accidents and are often associated with meniscal, cartilage, or neurovascular damage.

When Is Surgery Required?

Severe knee instability

Significant instability affecting daily function

Combined ACL, PCL, and PLC injuries

Multiple ligament ruptures

Posterolateral corner injury

With rotational instability of the knee

Athletes or physically active individuals

Active patients wanting to return to sports

Failure of conservative treatment

When non-surgical therapy is unsuccessful

Surgical Management

Treatment is individualized and depends on:

  • The number of injured ligaments
  • Involvement of the posterolateral corner
  • Patient activity level
  • Associated cartilage or bone injuries

Surgical reconstruction is performed using arthroscopic or combined arthroscopic–open techniques, aiming for anatomical restoration of all injured structures.

Rehabilitation

The rehabilitation program is individualized and follows specific phases:

0–6 weeks

Graft protection, swelling control

6–12 weeks

Restoration of motion and strength

3–6 months

Proprioception and functional training

6–9 months

Gradual return to sports