Mayo Clinic Sports Medicine Research uses a team approach to diagnose and treat knee dislocation and multiligament injuries. The surgeons design surgical instruments and techniques to improve the success of ligament reconstruction.
Faculty members collaborating on research related to knee dislocation and multiligament knee injury treatment include:
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Anatomic posterolateral corner two-tailed technique for lateral sided knee injuries provides excellent outcomes.
Woodmass JM, Sanders TL, Johnson NR, Wu IT, Krych AJ, Stuart MJ, Levy BA. Posterolateral corner reconstruction using the anatomical two-tailed graft technique: clinical outcomes in the multiligament injured knee. Journal of Knee Surgery. 2018;31:1031.
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Anatomic MCL reconstruction for patients with severe medial-sided injuries provides excellent outcomes.
Barrett IJ, Krych AJ, Pareek A, Johnson NR, Dahm DL, Stuart MJ, Levy BA. Short- to mid-term outcomes of anatomic MCL reconstruction with achilles tendon allograft after multiligament knee injury. Knee Surgery, Sports Traumatology, Arthroscopy. 2018;26:2952.
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After multiligament knee reconstruction, patients with poly-traumatic knee injuries have significantly worse outcomes than those with an isolated knee injury.
Woodmass JM, Johnson NR, Mohan R, Krych AJ, Levy BA, Stuart MJ. Poly-traumatic multi-ligament knee injuries: Is the knee the limiting factor? Knee Surgery, Sports Traumatology, Arthroscopy. 2018;26:2865.
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REVISION multiligament knee reconstruction provides excellent outcomes.
Woodmass JM, O'Malley MP, Krych AJ, Reardon PJ, Johnson NR, Stuart MJ, Levy BA. Revision multiligament knee reconstruction: Clinical outcomes and proposed treatment algorithm. Arthroscopy. 2018;34:736.
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All-inside, single-bundle PCLR demonstrated satisfactory clinical and functional outcomes comparable with previous other PCLR techniques.
Freychet B, Desai VS, Sanders TL, Kennedy NI, Krych AJ, Stuart MJ, Levy BA. All-inside posterior cruciate ligament reconstruction: Surgical technique and outcome. Clinical Sports Medicine. 2019; doi:10.1016/j.csm.2018.11.005.
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Surgical treatment of the PLC using a single-graft technique can result in satisfactory knee function and stable physical examination findings at minimum 2 years after surgery.
Sanders TL, Johnson NR, Pareek A, Krych AJ, Marx RG, Stuart MJ, Levy BA. Satisfactory knee function after single-stage posterolateral corner reconstruction in the multi-ligament injured/dislocated knee using the anatomic single-graft technique. Knee Surgery, Sports Traumatology, Arthroscopy. 2018; doi:10.1007/s00167-017-4631-6.
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In a series utilizing a modified Marx Achilles tendon, MCL reconstruction in the setting of MLKI demonstrated satisfactory clinical and functional outcomes, as well as patient satisfaction at short- to mid-term follow-up.
Barrett IJ, Krych AJ, Pareek A, Johnson NR, Dahm DL, Stuart MJ, Levy BL. Short- to mid-term outcomes of anatomic MCL reconstruction with Achilles tendon allograft after multiligament knee injury. Knee Surgery, Sports Traumatology, Arthroscopy. 2018; doi:10.1007/s00167-018-4843-4.
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Multiligament knee injuries with a vascular injury requiring emergent bypass vein graft have worse outcomes than those without vascular injury.
Sanders TL, Johnson NR, Levy NM, Cole PA Jr, Krych AJ, Stuart M, Levy BA. Effect of vascular injury on functional outcome in knees with multi-ligament injury: A matched-cohort analysis. Journal of Bone and Joint Surgery. 2017;99:1565.
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Anatomic single-graft technique in the multiligament injured/dislocated knee provides excellent outcomes.
Sanders TL, Johnson NR, Pareek A, Krych AJ, Marx RG, Stuart MJ, Levy BA. Satisfactory knee function after single-stage posterolateral corner reconstruction in the multi-ligament injured/dislocated knee using the anatomic single-graft technique. Knee Surgery, Sports Traumatology, Arthroscopy. 2018;26:1258.
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Patients undergoing total knee arthroplasty (TKA) after prior multiligament knee surgery (MLKS) have higher rates of complications including re-operation and infection and lower component survivorship than do those with no previous knee surgery.
Pancio SI, Soursa PL, Krych AJ, Abdel MP, Levy BA, Dahm DL, Stuart MJ. Increased risk of revision, reoperation, and implant constraint in TKA after multiligament knee surgery. Clinical Orthopaedics and Related Research. 2017;475:1618.
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Reconstruction is favored in patients treated with ACL/PCL/MCL surgery compared with those with ACL/PCL/LCL surgery. Patients with medial-sided repair had significantly worse outcomes than those with reconstruction.
King AH, Krych AJ, Prince MR, Pareek A, Stuart MJ, Levy BA. Surgical outcomes of Medial Versus Lateral Multiligament-Injured, Dislocated Knees. Arthroscopy. 2016;32:1814.
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Peroneal nerve injuries in the multiligament injured/dislocated knee can severely limit the ability to walk normally, and understanding the best care strategies is paramount to a successful outcome.
O'Malley MP, Pareek A, Reardon P, Krych AJ, Stuart MJ, Levy BA. Treatment of peroneal nerve injuries in the multiligament injured/dislocated knee. Journal of Knee Surgery. 2016;29:287.
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Outcomes for knee dislocation are significantly better for those under 30 years of age, but patients over 30 still have successful outcomes.
Levy NM, Krych AJ, Hevesi M, Reardon PJ, Pareek A, Stuart MJ, Levy BA. Does age predict outcome after multiligament knee reconstruction for the dislocated knee? 2- to 22-year follow-up. Knee Surgery, Sports Traumatology, Arthroscopy. 2015;23:3003.
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Although medial patellofemoral ligament (MPFL) tears are commonly seen in multiligament knee injuries, surgery specifically for the MPFL doesn't appear to be necessary.
Allen BJ, Krych AJ, Engasser W, Levy BA, Stuart MJ, Collins MS, Dahm DL. Medial patellofemoral ligament tears in the setting of multiligament knee injuries rarely cause patellar instability. The American Journal of Sports Medicine. 2015;43:1386.
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Early operative treatment of the multiligament-injured knee yields improved functional and clinical outcomes compared with nonoperative management or delayed surgery. Repair of the posterolateral corner may yield higher revision rates compared with reconstruction.
Levy BA, Dajani KA, Whelan DB, Stannard JP, Fanelli GC, Stuart MJ, Boyd JL, MacDonald PA, Marx RG. Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy. 2009; doi:10.1016/j.arthro.2009.01.008.