Total Knee Arthroplasty as the Initial and Definitive Treatment for the Multiligament Injured Knee

Background Multiligament knee injuries (MLKIs) are complex injury patterns that pose challenges for patients and surgeons alike. The objective of this study was to evaluate the clinical and functional perioperative outcomes of a cohort of patients with evidence of pre-existing knee osteoarthritic changes that underwent total knee arthroplasty (TKA) as the initial and definitive treatment for MLKI. Methods Patients from 2 tertiary care centers that underwent TKA as primary treatment for their MLKI within 1 year from their initial time of injury were retrospectively identified for study inclusion. Range of motion, and Knee Society Scores were evaluated for all patients. Perioperative complications as well as TKA component types and degrees of implant constraint were also analyzed. Results Twelve patients met study inclusion criteria. Mean follow-up time was 40 months (range 24 to 86 mos). Mean time from MLKI to TKA was 5 months (range 3 days to 11 months). Mean age was 61 years (range 51 to 78). Mean postoperative knee range of motion was 1-106 degrees at last follow-up. Knee Society Scores improved by an average of 129 points at last follow-up. Two patients required rotating hinge TKA components with all others requiring lesser degrees of implant constraint. There were no instances of postoperative knee instability and no patients required revision TKA surgery at last follow-up. Conclusions TKA is a viable primary treatment option for MLKI in older patients with pre-existing multicompartmental knee osteoarthritis. In this patient population, TKA may allow for improved function and adequate stability of the multiligament injured knee. Study Design Retrospective case series. Level of Evidence IV.