Geisinger Health System Orthopaedics, Danville, PA.
Sports Med Arthrosc Rev. 2020 Sep;28(3):100-109. doi: 10.1097/JSA.0000000000000276.
The multiple ligament injured knee is a complex problem in orthopedic surgery. These injuries may or may not present as acute knee dislocations, and careful assessment of the extremity vascular and neurological status is essential because of the possibility of arterial and/or venous compromise, and nerve injury. These complex injuries require a systematic approach to evaluation and treatment. Physical examination and imaging studies enable the surgeon to make a correct diagnosis and formulate a treatment plan. Knee stability is improved postoperatively when evaluated with knee ligament rating scales, arthrometer testing, and stress radiographic analysis. Surgical timing depends upon the injured ligaments, vascular status of the extremity, reduction stability, and the overall health of the patient. The use of allograft tissue is preferred because of the strength of these large grafts, and the absence of donor site morbidity.
多韧带损伤的膝关节是骨科的一个复杂问题。这些损伤可能表现为急性膝关节脱位，也可能不表现为急性膝关节脱位，因此必须仔细评估肢体的血管和神经状态，因为有可能发生动脉和/或静脉受压和神经损伤。这些复杂的损伤需要系统的评估和治疗方法。体格检查和影像学研究使外科医生能够做出正确的诊断和制定治疗计划。术后使用膝关节韧带评分、关节计测试和应力放射分析可改善膝关节稳定性。手术时机取决于损伤的韧带、肢体的血管状态、复位稳定性和患者的整体健康状况。同种异体组织的使用是首选，因为这些大移植物强度高，且不存在供区发病率。
