Multi-ligament knee injuries can occur from non-contact and contact injuries and knee (tibiofemoral) dislocations. Knee dislocations can result in a sprain (tear) of multiple (usually three of the four) major ligaments of the knee. There are four main knee ligament complexes including the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and the posterolateral corner (PLC or LCL in the below figure). These injuries most commonly occur to both cruciate ligaments (ACL and PCL) and one collateral ligament. Ligaments are structures that help keep the normal relationship of the femur (thigh bone) and the tibia (shinbone). They allow motion until certain extremes, and any motion beyond these extremes results in a ligament injury. Injury to multiple ligaments results in difficulty in performing sports and even activities with day-to-day living.
Dr. Chudik performs ligament reconstruction surgery with the assistance of an arthroscope, a camera that inserts into small incisions and allows him to view the inside of the knee joint. The surgery usually is performed as an outpatient procedure (go home the same day) with general anesthesia and a nerve block. The nerve block involves injecting numbing medicine around the nerves of the leg by the anesthesiologist just prior to the surgery. The torn ligaments are replaced by a graft (either from the patient’s body and/or a donor). Each graft type has its own risks and benefits. Prior to surgery, Dr. Chudik will discuss the type of graft(s) that is best for you. During the surgery, the ligaments, meniscus, and cartilage of the knee are also evaluated and treated appropriately. The grafts are placed anatomically where the injured ligament used to be. The grafts are held in position with special fixation devices until it heals in place to replace the torn ligament. The fixation devices usually do not need to be removed.