➢ Multiligament knee injuries (MLKIs) encompass a heterogeneous spectrum of severe knee trauma, presenting ongoing challenges in their diagnosis, classification, management, and postoperative rehabilitation. This review synthesizes the current evidence with expert clinical perspectives to summarize key principles in evaluation and management. ➢ Thorough clinical examination, stress radiography, and magnetic resonance imaging can improve injury characterization and objective quantification of pathologic laxity to guide surgical planning. ➢ Contemporary reconstruction strategies emphasize the detection of posteromedial corner, posterolateral corner, and meniscal pathologies, while recognizing that appropriate management of these associated injuries protects cruciate reconstruction grafts. ➢ Treatment timing remains controversial, with increasing evidence and consensus for early, comprehensive single-stage surgery when feasible in selected patients. ➢ Modern approaches to MLKI management should prioritize restoration of anatomy, biomechanical stability, meticulous planning to avoid tunnel convergence, and rehabilitation strategies.
Published abstract, J Bone Joint Surg Am 2026. Copyright remains with the authors and publisher.
➢ Multiligament knee injuries (MLKIs) encompass a heterogeneous spectrum of severe knee trauma, presenting ongoing challenges in their diagnosis, classification, management, and postoperative rehabilitation. This review synthesizes the current evidence with expert clinical perspectives to summarize key principles in evaluation and management. ➢ Thorough clinical examination, stress radiography, and magnetic resonance imaging can improve injury characterization and objective quantification of pathologic laxity to guide surgical planning. ➢ Contemporary reconstruction strategies emphasize the detection of posteromedial corner, posterolateral corner, and meniscal pathologies, while recognizing that appropriate management of these associated injuries protects cruciate reconstruction grafts. ➢ Treatment timing remains controversial, with increasing evidence and consensus for early, comprehensive single-stage surgery when feasible in selected patients. ➢ Modern approaches to MLKI management should prioritize restoration of anatomy, biomechanical stability, meticulous planning to avoid tunnel convergence, and rehabilitation strategies.
Published abstract, J Bone Joint Surg Am 2026. Copyright remains with the authors and publisher.