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Advances in Treatment of Complex Knee Injuries

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Abstract

Multi-ligament knee injuries constitute a challenging entity, because of the complexity of diagnosis, associated injuries, reconstruction procedures, and the postoperative rehabilitation program. A comprehensive clinical and radiographic examination is essential to identify all injured structures and to develop a detailed plan of treatment. Reconstruction of all injured ligaments and concomitant injuries in one stage is advocated in order to achieve early mobilization and to avoid joint stiffness. During multi-ligament knee reconstruction surgery, detailed planning of all steps is mandatory. Several technical aspects require consideration, such as the graft choice, the sequence of ligament reconstruction, tunnel position and orientation to avoid tunnel convergence, graft tensioning order, and the postoperative rehabilitation protocol. Detailed preoperative planning and close attention to details during surgery are key to achieving successful outcomes. Rehabilitation after a multi-ligament reconstruction surgery typically requires 9–12 months, after which returning to full activities can be permitted. In this chapter, the principles of multi-ligament injuries including patient demographics and associated injuries, diagnosis and treatment approaches, surgical pearls for avoiding tunnel convergence, and the graft tensioning sequence, outcomes, and prevalence of osteoarthritis after knee dislocation surgery and future perspectives are discussed.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Oslo University Hospital and University of Oslo, Oslo, Norway

    Gilbert Moatshe, Marc J. Strauss & Lars Engebretsen

  2. OSTRC, The Norwegian School of Sports Sciences, Oslo, Norway

    Gilbert Moatshe & Lars Engebretsen

  3. Steadman Philippon Research Institute, Vail, CO, USA

    Gilbert Moatshe, Jorge Chahla & Robert F. LaPrade

  4. The Steadman Clinic, Vail, CO, USA

    Robert F. LaPrade

Authors
  1. Gilbert Moatshe
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  2. Jorge Chahla
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  3. Marc J. Strauss
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  4. Robert F. LaPrade
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  5. Lars Engebretsen
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Corresponding author

Correspondence to Gilbert Moatshe .

Editor information

Editors and Affiliations

  1. Orthopaedic Surgery, Academic Medical Center, AZ Amsterdam, The Netherlands

    Gino M. M. J. Kerkhoffs

  2. Orthopaedics and Trauma, University College London Hospitals, London, UK

    Fares Haddad

  3. Kantonsspital Baselland , Bruderholz, Switzerland

    Michael T. Hirschmann

  4. Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden

    Jón Karlsson

  5. Clinique d’Eich, Centre Hospitalier de Luxembourg Clinique d’Eich, Luxembourg, Luxembourg

    Romain Seil

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Moatshe, G., Chahla, J., Strauss, M.J., LaPrade, R.F., Engebretsen, L. (2018). Advances in Treatment of Complex Knee Injuries. In: Kerkhoffs, G.M.M.J., Haddad, F., Hirschmann, M.T., Karlsson, J., Seil, R. (eds) ESSKA Instructional Course Lecture Book. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56127-0_1

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  • DOI: https://doi.org/10.1007/978-3-662-56127-0_1

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