Multi-ligament knee injury (MLKI) is a rare but severe injury with potential devastating complications. More awareness and knowledge is needed among health care professionals to prevent delay or missing of this diagnosis.
The primary goal of this study was to investigate return to sports and return to work after a MLKI. Secondary outcomes were patient reported outcome measures (PROMs), the extent of the damage (i.e. which ligaments were involved and in which combination), time between trauma, diagnosis and treatment, type of treatment and neurovascular damage.
Study design: Descriptive case series.
A database search was performed to identify all patients with MLKI presented in our hospital between 2010 and 2017. MLKI was defined as (1) Schenck KD-II or higher, (2) combined posterior cruciate ligament (PCL) and posterolateral corner (PLC) injury, or (3) combined PCL and medial collateral ligament (MCL). Pre-defined variables were collected from patient files and patient questionnaires. Pearson product-moment correlation coefficient were computed to assess the relationship between different variables and the PROMs.
31 patients were included in this study. The response rate for our primary outcomes was 87.1%. The overall return to sports rate after a MLKI was 88.5%, but only 23.1% returned to their pre-injury level of sports. 83.3% of the patients were able to return to work and 70.0% did return to pre-injury work level. A higher age at time of trauma correlated with a lower IKDC score (r=-0.60, p=0.002), a lower Lysholm score (r=-0.48, p=0.016), and higher pain scores during rest (r=0.67, p<0.001), walking (r=0.67, p<0.001) and sports (r=0.44, p=0.030). A substantial delay between trauma and diagnosis of more than three months was seen in 32.3% of the patients.
This study showed a relatively high overall return to sports and work after a MLKI. However, less than a quarter of the patients returned to their pre-injury level of sports. An important finding was the substantial number of patients with a delay between trauma and diagnosis.
This study contributes to more awareness of and knowledge about MLKI among involved physicians, which is essential to reduce these delays.