Multiligamentous knee reconstruction.

What criteria are used for determining whether to repair or reconstruct multiligamentous knee injuries? Timing is perhaps the most important factor that helps to determine whether to repair or reconstruct multiligamentous knee injuries. Repair is a viable option only in the acute setting and only for certain ligaments (collaterals and corners). Cruciate injuries, whether in isolation or in the context of multiligamentous knee injury, are usually reconstructed. With surgical delay, reconstruction may be the only option. Some clinicians favor reconstruction acutely. This is performed with the belief that plastic deformation may occur to the ligaments that could allow for knee instability even with anatomic repair. Conversely, early surgery may also lead to higher rates of arthrofibrosis.