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Evidence. Clarity. Practice.

© 2026 OrthoVellum. For educational purposes only.

Not medical advice. Verify clinically important information against current local guidance.

Back to Research
Level IMust KnowSports MedicineSystematic Review

Evidence brief

Multiligament Knee Injury

Management of Multiligament Knee Injuries

Authors
Levy BA, Dajani KA, Whelan DB, et al
Journal
J Bone Joint Surg Am
Year
2009

Key Findings

  • 1

    Surgical treatment superior to non-operative for most patterns

  • 2

    Posterolateral corner injuries require early surgery (<3 weeks)

  • 3

    ACL and PCL can be reconstructed simultaneously or staged

  • 4

    Vascular assessment mandatory

  • 5

    Outcomes generally good but rarely normal

Clinical Implications

Multiligament knee injuries require systematic assessment, vascular evaluation, and often surgical reconstruction. Posterolateral corner injuries are time-sensitive and should be addressed early.

Teaching Note

Critical exam topic. Initial assessment: vascular exam (ABI, angiogram if ABI <0.9), nerve function. Surgical timing: PLC within 3 weeks. Staged vs single-stage reconstruction. Know Schenck classification. Expect residual laxity even after surgery.

Citation

Levy BA et al. Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy. 2009;25(4):430-438.

PubMedDOI

Evidence Level

I

Level I

Systematic review of RCTs or high-quality RCT

Topics

knee dislocationmultiligamentPCLposterolateral corner

Related Topics

  • Knee Dislocation
  • Posterolateral Corner
  • Multiligament Reconstruction

External Links

View on PubMedView via DOI

Related Papers

I

ACL Graft Comparison

Xie X (2015)

II

MOON ACL Cohort

MOON Knee Group (2011)

II

MARS Revision ACL Study

MARS Group (2014)

III

Meniscal Repair Outcomes

Stein T (2010)