SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Early surgery and number of injured ligaments are associated with postoperative stiffness following multi-ligament knee injury surgery: a systematic review and meta-analysis.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Outcomes after multiligament knee injury worsen over time: A systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Postoperative stiffness requiring fibroarthrolysis does not impair long-term outcomes after multiligament knee reconstruction.Journal of experimental orthopaedics · 2026Article
- Multiligament-injured knee: what the general orthopedic surgeon should know.EFORT open reviews · 2026Review
- Surgical Management of Multi-Ligamentous Knee Injuries: Current Concepts and Case Report of a Complex KD-IV Case.Reports (MDPI) · 2026Article
- Outcomes Following Multiligament Knee Injuries: A Systematic Review of Studies With a Minimum 7-Year Follow-up.Orthopaedic journal of sports medicine · 2026Review
- Risk Factors for Arthrofibrosis in Schenck KD 3 and 4 Multiligament Knee Injury Patients.Orthopaedic journal of sports medicine · 2025Article
- Characterization of posterior capsular injury for preoperative planning in closed knee injuries: A narrative review.Journal of orthopaedics · 2025Review
- Single-Stage vs. Multi-Stage Reconstruction in Multi-Ligament Knee Injuries: A Systematic Review and Meta-Analysis of Outcomes and Complications.Journal of clinical medicine · 2025Review
- Outcomes of acute versus delayed multi-ligament knee injury reconstruction: A retrospective analysis with mean 3.6-year follow-up.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- New algorithm for management of multiligament knee injuries: A tertiary level trauma center experience.Journal of experimental orthopaedics · 2025Article
- Outcomes of arthroscopic one-stage repair and reconstruction of Schenck II-IV knee dislocations with multiple ligament injuries: a single-center study.BMC surgery · 2025Article
- Knee joint dislocations-Current epidemiology and treatment in Germany.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- How do surgically treated multiligamentous knee injuries affect overall complication rate and especially stiffness? A systematic review.Knee surgery & related research · 2025Review
- Multiligament knee injury patients with limited access to post-operative rehabilitation exhibit similar patient-reported outcomes: A retrospective cohort study.Journal of experimental orthopaedics · 2025Article
- A Systematic Review of all Published Systematic Reviews (SRs) on Multiligament Knee Injuries (MLKIs).Indian journal of orthopaedics · 2025Review
- 3D printing technology is a more accurate tool than an experienced surgeon in performing femoral bone tunnels in multi-ligament knee injuries.Journal of experimental orthopaedics · 2025Article
- Timing of Surgery & Rehabilitation After Multiligamentous Knee Reconstruction.Current reviews in musculoskeletal medicine · 2024Review
- A novel minimally invasive nonanatomical single-bundle medial collateral ligament reconstruction technique with a short isometric construct Achilles tendon allograft: A surgical description with clinical and radiological outcomes in multiligament knee injury patients.Journal of experimental orthopaedics · 2024Article
- Effect of Timing of Surgery on the Outcomes and Complications in Multi-ligament Knee Injuries: An Overview of Systematic Reviews and A Meta-analysis.Indian journal of orthopaedics · 2024Review
- Multiligament knee injuries. Ten years' experience at a public university, level I Trauma Center.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo perform a systematic review and meta-analysis to investigate the rate of stiffness after multi-ligament knee injury (MLKI) surgery and identify potential risk factors associated with postoperative stiffness.
methodsThis study was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Registration was done on the PROSPERO International Prospective Register of Systematic Reviews (CRD42022321849). A literature search of PubMed, Ovid, Embase, and Cochrane Library databases was conducted in October 2022 for clinical studies reporting postoperative stiffness after MLKI surgery. A quality assessment was performed using the Methodological Index of Non-Randomized Studies (MINORS) grading system. The following variables were extracted from studies for correlation to postoperative stiffness: study characteristics, cohort demographics, Schenk classification, neurovascular injury, mechanism of injury, external fixator placement, timing of surgery, and concomitant knee injuries.
resultsThirty-six studies comprising 4,159 patients who underwent MLKI surgery met the inclusion criteria, including two Level-II, fourteen Level-III, and twenty Level-IV studies. The average MINOR score of the studies was 14. The stiffness rate after MLKI was found to be 9.8% (95% CI 0.07-0.13; p < 0.01; I
conclusionPerforming surgery within the first 3 weeks following MLKI, or concomitant injury of ≥ 3 ligaments, are significantly associated with increased risk of postoperative stiffness. These findings can be utilized by surgeons to decide the timing of surgery for MLKI surgeries especially in which ≥ 3 ligaments are injured. LEVEL OF EVIDENCE: Level IV.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.