Arthroscopic reconstruction of multiligament knee injuries associated with femoral shaft fractures: A prospective observational study at a tertiary care teaching hospital.
DOI:
https://doi.org/10.51168/pkehyr79Keywords:
Multiligament Knee Injury, arthroscopic reconstruction, femoral shaft fracture, knee stability, Lysholm scoresAbstract
Background:
Multiligament knee injuries (MLKI) associated with femoral shaft fractures are uncommon but severe injuries resulting from high-energy trauma. Delayed diagnosis of ligamentous injuries may compromise functional recovery, making timely arthroscopic reconstruction an important component of treatment.
Objective:
To evaluate the clinical and functional outcomes of arthroscopic reconstruction in patients with multiligament knee injuries associated with femoral shaft fractures.
Methods:
This prospective observational study included 20 consecutive patients with femoral shaft fractures and concomitant MLKI treated at a tertiary-care teaching hospital. Fractures were initially stabilized using intramedullary nailing, followed by arthroscopic ligament reconstruction after 3–6 weeks. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) and Lysholm knee scores over a 12-month follow-up. Statistical analysis was performed using paired t-tests, with p<0.05 considered statistically significant.
Results:
The mean age of participants was 32.5 ± 8.2 years, with males comprising 80% of the study population. Road traffic accidents accounted for 75% of injuries, while combined anterior cruciate ligament and posterior cruciate ligament injuries were the most common pattern (30%). The mean IKDC score improved significantly from 32.4 ± 6.5 preoperatively to 78.6 ± 8.2 at 12 months, and the mean Lysholm score increased from 40.2 ± 7.1 to 85.3 ± 6.9 (both p<0.001). Knee stiffness occurred in two patients (10%), graft failure in one patient (5%), and no postoperative infections were observed.
Conclusion:
Arthroscopic reconstruction following staged management of femoral shaft fractures provides excellent functional recovery, improved knee stability, and a low complication rate in patients with MLKI.
Recommendation:
Arthroscopic reconstruction should be considered an effective treatment option for appropriately selected patients with MLKI associated with femoral shaft fractures. Larger multicenter studies with longer follow-up are recommended to validate these findings.
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