AbdelKawi Ayman, Fargaly Mohammed, Eid Gaber, El Assal Maher, Elkady Hesham, Fetih Tarek N
Orthopaedics and Traumatology Assiut University Hospital Assuit University Assuit Egypt.
Orthopedic Department Alazhar University, Assuit University Assuit Egypt.
J Exp Orthop. 2025 Jul 27;12(3):e70387. doi: 10.1002/jeo2.70387. eCollection 2025 Jul.
Multiligament knee injuries (MLKIs) are severe orthopedic traumas frequently associated with concomitant structural damage, often leading to significant long-term morbidity. This study aimed to evaluate the rate of return to work (RTW) following the management of MLKIs using a standardized treatment algorithm.
This prospective interventional study included patients with MLKIs who presented to a tertiary trauma center between 2019 and 2022. A total of 32 patients (30 males and 2 females) were enrolled and classified according to the Schenck classification system. The median age at the time of injury was 31 years (range: 17-60 years). The mechanism of injury was high-energy trauma in 21 patients, sports-related trauma in eight patients, and low-energy trauma in three patients. Clinical outcomes were assessed at final follow-up using the Lysholm score, International Knee Documentation Committee (IKDC) subjective knee evaluation form, University of California Los Angeles (UCLA) activity score, and return to work status.
At a mean 2-year postoperative follow-up, the average range of motion across all patients was 134.2° ± 16.6°. The mean postoperative Lysholm, IKDC, and UCLA scores were 86.4 ± 12.6, 65.9 ± 9.7, and 6.9 ± 2.2, respectively. Notably, 90.6% of the patients achieved a successful return to their previous work. The proportion of patients returning to work was significantly higher in the Knee Dislocation Injury (KDI) group compared to the other three Schenck classification groups, which showed no significant difference among themselves. Radiographic evidence of osteoarthritis (OA) was observed in four cases (12.5%).
This study demonstrates that satisfactory to excellent short-term clinical outcomes, including a high rate of return to work, can be achieved following ligament reconstruction for multiligament knee injuries when utilizing a standardized treatment algorithm. However, the potential for long-term complications, such as the development of knee osteoarthritis, warrants careful consideration and continued monitoring.
Level IV.
多韧带膝关节损伤（MLKIs）是严重的骨科创伤，常伴有结构损伤，往往导致严重的长期发病率。本研究旨在评估采用标准化治疗方案治疗MLKIs后的重返工作率（RTW）。
这项前瞻性干预性研究纳入了2019年至2022年间在三级创伤中心就诊的MLKIs患者。共纳入32例患者（30例男性和2例女性），并根据申克分类系统进行分类。受伤时的中位年龄为31岁（范围：17 - 60岁）。损伤机制为高能量创伤21例，运动相关创伤8例，低能量创伤3例。在最终随访时，使用Lysholm评分、国际膝关节文献委员会（IKDC）主观膝关节评估表、加利福尼亚大学洛杉矶分校（UCLA）活动评分和重返工作状态来评估临床结果。
术后平均2年随访时，所有患者的平均活动范围为134.2°±16.6°。术后Lysholm、IKDC和UCLA评分的平均值分别为86.4±12.6、65.9±9.7和6.9±2.2。值得注意的是，90.6%的患者成功重返原工作岗位。与其他三个申克分类组相比，膝关节脱位损伤（KDI）组患者重返工作的比例显著更高，而其他三个组之间无显著差异。4例（12.5%）观察到骨关节炎（OA）的影像学证据。
本研究表明，采用标准化治疗方案对多韧带膝关节损伤进行韧带重建后，可取得满意至优异的短期临床结果，包括较高的重返工作率。然而，膝关节骨关节炎等长期并发症的可能性值得仔细考虑并持续监测。
四级。
