Surgical Management of Complex Multiligament Knee Injury: Case Report

Abstract

Multiligament knee injuries (MLKIs) frequently require immediate intervention to prevent severe complications, including vascular injury. We present the case of a 51-year-old male who sustained a traumatic right knee dislocation following a motor vehicle accident. The patient exhibited significant tibiofemoral dissociation with Grade 3 instability, classified as Schenck KD IV. Immediate reduction and external fixation were performed, followed by definitive surgical management, which included fibular sling, MPFL and MCL repair, and double-bundle and double-tunnel ACL and PCL reconstruction with looped proximal tibial fixation. The patient showed an excellent early postoperative outcome, with minimal edema, manageable moderate pain, and a full range of motion by the 30-day follow-up. This case underscores the effectiveness of combining fibular sling, MPFL, and MCL, with anatomical double-bundle ACL and PCL reconstruction in the treatment of complex MLKIs. The level of evidence is IV.