Complex knee injuries are a complex problem. When more than one ligament in the knee is torn, this is called a multi-ligamentous or poly-ligamentous injury. Unlike a more routine knee injury, such as an ACL tear by itself, the other supporting ligaments are also torn. This injury causes the knee to be unstable in more than one direction, which we call multi-directional instability.
Using the best techniques, supported by the most up to date research, these patients are able to get back to their sport or work with the best function possible.
The treatment of these injuries requires a thorough understanding of the anatomy and the different techniques to reconstruct them. Seeking the care of an orthopedic surgeon who routinely addresses these issues is vital to obtaining the best possible outcomes.
Some injuries can heal themselves. The MCL, or medial collateral ligament, can often heal itself. In some cases, when multiple ligaments have been torn, the first step is to give the MCL a chance to heal on its own. Even if surgery is needed, allowing parts of the knee to first heal will make the surgery and the recovery easier. The PCL, or posterior cruciate ligament, also often has the potential to heal or stabilize on its own. This may also be true in some cases of ACL injuries, and FCL/fibular collateral ligament/posterolateral corner injuries.
In some cases, such as the patient in the video, multiple ligaments need to be fixed. In nearly all cases, this is best done in one setting, with one surgery to address all of the issues. This, in combination with performing repairs that are anatomical in nature (putting ligaments back exactly where they belong) allows for an expedited recovery, with early motion and rehabilitation.
The knee that you are watching in the video had ACL reconstruction, double-bundle PCL reconstruction, and MCL reconstruction performed. This was after allowing a lower grade FCL injury to heal on its own.
He is doing great, and back on the slopes!
