Surgical techniques of open surgical reconstruction in the multiple-ligament-injured knee

Multiple-ligament injuries of the knee present the orthopedic surgeon with a myriad of management and treatment challenges. Often the result of high-energy trauma, such as motor vehicle and industrial accidents, the multiple-ligament-injured knee is increasing in frequency among athletes participating in a variety of sports. These injuries can be treated by arthroscopic techniques, open techniques, or a combination of the two. The open surgical approach has several advantages. First, the approach is relatively straightforward and is effective in minimizing operating-room time. Second, all structures can be evaluated directly and fixed securely. The purpose of this article is to present the open operative techniques that we use to reconstruct and repair the multiple-ligament-injured knee. In the treatment of these injuries, our goal is to create an environment of controlled arthrofibrosis to provide the patient with a reconstructed knee that is functionally stable.