The knee is the most complex joint in the body formed by the articulation between the thigh bone (femur) and the shinbone (tibia). These bones are held together by four strong rope like structures called ligaments. The knee has four major ligaments – the anterior cruciate ligament, posterior cruciate ligament, lateral collateral ligament, and medial collateral ligament .Two collateral ligaments are present on the sides of the knee and control the sideway movements of the knee. The anterior and posterior cruciate ligaments which are present in the center of the knee joint control the back and forth movement of the knee.
Multiple ligament knee injuries are common in athletes involved in contact sports such as soccer, football and basketball. Multi-ligament injuries occur as a result of major trauma such as a direct blow to the knee, or a fall from a height, or motor vehicle trauma. Patients with multi-ligament knee injuries may experience pain, swelling, limited range of motion, injuries to nerves and arteries of the leg, and knee instability.
Knee ligament injuries are graded based on the severity of injury. In grade I the ligament is mildly damaged and slightly stretched, but the knee joint is stable. In grade II there is a partial tear of the ligament. In grade III there is a complete tear of the ligament and the ligament is divided into two halves making the knee joint unstable.
Most multi-ligament knee injuries require surgery to reconstruct the ligaments. Reconstruction of the torn ligaments using a tissue graft taken from another part of the body, or from a donor is known as complex ligament reconstruction. Surgical reconstruction is usually performed as a minimally invasive surgery where an arthroscope with a miniature camera is inserted through a tiny incision to enable the surgeon to view the inside of the knee on a large screen. Small surgical instruments are inserted through the other tiny incisions around the knee. The damaged ligament is replaced by the graft and is fixed to the femur and tibia using metallic screws.
After complex ligament reconstruction, the graft heals over a period of a few months and most patients are able to return to their high level sport after a period of rehabilitation.
As the surgery is done through small incisions, it provides the following benefits: