Morsi Elsayed, Adawy Adel, Rabie Mohamed, Abdelrazek Ahmed, Elashab Mohamed, Morsi Aya
Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Faculty of Medicine, Banha University, Banha, Egypt.
Indian J Orthop. 2025 Apr 11;59(4):488-493. doi: 10.1007/s43465-025-01375-9. eCollection 2025 Apr.
Multiligament knee injuries (MLKI) constitute a complex and challenging problem. They can have life-modifying consequences, such as the development of osteoarthritis, and an inability to return to work or sport. At present, there is insufficient high-level evidence or expert consensus to support one management strategy over another.
The purpose of this article is to review the updates of the debates about multiligament knee injuries, diagnosis, treatment options, and rehabilitation protocols. This article also aimed to elucidate expert opinions on controversial issues in MLKI from scholars from Egypt and the Arab world.
Comprehensive review; Level of evidence, 5.
Medline, Embase, PubMed, and Physiotherapy Evidence Database (PEDro) databases were searched between inception and February 2024. The terms: 'multi-ligament' OR 'multiligament' OR 'multi ligament' OR multiple ligaments' AND 'knee' were used to extract relevant studies.
Overall, 1009 eligible studies were identified. After applying inclusion and exclusion criteria, there were 251 articles; of which there were 24 systematic reviews and 227 clinical studies.
The relative rarity of MLKI makes it difficult to perform good-powered prospective randomized studies evaluating these injuries. The debates are expected due to the diversity of presentations of MLKI with regard to types of injured ligaments, site of injury within the ligament, time of presentation, and the different management methods. Thorough knowledge and experience are mandatory to tailor a diagnostic workup and management plan for each case.
膝关节多韧带损伤（MLKI）是一个复杂且具有挑战性的问题。它们可能会产生改变生活的后果，例如骨关节炎的发展，以及无法重返工作或运动。目前，没有足够的高级证据或专家共识来支持一种管理策略优于另一种。
本文的目的是回顾关于膝关节多韧带损伤、诊断、治疗选择和康复方案的争论的最新情况。本文还旨在阐明埃及和阿拉伯世界学者对MLKI中争议问题的专家意见。
综合综述；证据水平，5。
在数据库建立至2024年2月期间，检索了Medline、Embase、PubMed和物理治疗证据数据库（PEDro）。使用“多韧带”或“多韧带损伤”或“多条韧带”以及“膝关节”等术语来提取相关研究。
总体而言，共识别出1009项符合条件的研究。应用纳入和排除标准后，有251篇文章；其中有24篇系统评价和227篇临床研究。
MLKI相对罕见，这使得进行评估这些损伤的有力的前瞻性随机研究变得困难。由于MLKI在损伤韧带类型、韧带内损伤部位、就诊时间和不同管理方法方面表现形式多样，因此争论是可以预料的。为每个病例制定诊断检查和管理计划需要全面的知识和经验。
