Multiligament Knee Injury

A multiligament knee injury (MLKI) occurs when two or more of the knee’s major ligaments are torn — typically the ACL, PCL, MCL, LCL and/or posterolateral corner (PLC). These injuries usually result from high-energy trauma (sport, falls, road collisions) and can cause severe instability, swelling and pain. Prompt assessment and a clear plan are essential to protect the joint and return to activity safely.

At The New Foscote Hospital, you can access rapid consultant orthopaedic assessment, on-site MRI, specialist physiotherapy, and—where needed—staged surgical reconstruction tailored to your sport and goals.

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Symptoms

• Knee feels unstable or “gives way”
• Large swelling (haemarthrosis) and stiffness
• Pain on weight-bearing and reduced range of motion
• Difficulty on stairs, uneven ground or changing direction
• Numbness or altered sensation if nerves are affected (e.g. common peroneal nerve)

Severe ligament injuries can be associated with meniscal, cartilage or nerve/artery damage and need urgent evaluation.

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Causes And Risk Factors

• Contact or high-velocity sports injuries (football, rugby, skiing)
• Road traffic or work-related trauma
• Knee dislocation (often spontaneously reduced before assessment)
• Previous ligament injury with inadequate rehabilitation

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Diagnosis At The New Foscote Hospital

Your knee specialist will perform a detailed examination (including Lachman, posterior drawer, varus/valgus and dial tests) and arrange targeted imaging:

• MRI (on site) to define all ligament, meniscal and cartilage injuries
• X-rays (including stress views where appropriate)
• CT when bony injury is suspected

Orthopaedic Services
Meet Our Consultants
Imaging – MRI

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Treatment Options

Management is individualised, considering injury pattern, tissue quality, activity level and timing from injury.

Initial Care

• Protect, brace and crutches to stabilise the knee
• Swelling control and early supervised range-of-motion
• Screening for neurovascular compromise and associated injuries

Non-Surgical Management (selected cases)

• Appropriate for partial tears, lower-demand patients or specific patterns with good stability in a brace
• Structured physiotherapy: swelling control, ROM, strength, proprioception

Surgical Management

• Staged or single-stage reconstruction/repair of injured ligaments (e.g., ACL/PCL reconstructions, MCL/LCL/PLC repairs or reconstructions)
• Meniscal or cartilage procedures as indicated
• Individualised graft choice (autograft/allograft) and technique to restore stability while protecting future joint health

Your surgeon will explain the recommended sequence, risks and expected outcomes for your specific pattern of injury.

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Recovery And Rehabilitation

Rehabilitation is crucial to outcome:

• Protected weight-bearing and brace initially, with guided progression
• Early range of motion, then progressive strength and neuromuscular control
• Proprioception and sport-specific drills introduced in phases
• Typical return to straight-line running: 3–4 months (pattern-dependent)
• Return to pivoting/contact sport: 9–12+ months, based on objective testing and surgeon/physio guidance

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When To Seek Specialist Help

Book a consultation if you have:

• A knee that gives way or feels unstable after injury
• Large swelling and difficulty weight-bearing
• Symptoms persisting despite rest and basic rehab
• Concern about safely returning to work or sport

Early, accurate diagnosis and a structured plan reduce the risk of ongoing instability and cartilage damage.