SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Outcomes after multiligament knee injury worsen over time: A systematic review and meta-analysis.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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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
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Diagnosis, Treatment, and Current Controversies in Multiligament Knee Injuries: A Narrative Review.Cureus · 2026Review
- 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
- Outcomes Following Multiligament Knee Injuries: A Systematic Review of Studies With a Minimum 7-Year Follow-up.Orthopaedic journal of sports medicine · 2026Review
- Heterotopic Ossification After Multiligament Knee Injury Is Associated With Knee-Spanning External Fixation and Central Nervous System Trauma.Orthopaedic journal of sports medicine · 2026Article
- Multiligament Knee Injuries: A 15-Year Clinical and Epidemiological Analysis at a Tertiary Referral Center.Cureus · 2026Article
- Evaluation and Management of Knee Dislocations in Low-income Settings: Evidence-based Strategies and Practical Considerations.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 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
- New algorithm for management of multiligament knee injuries: A tertiary level trauma center experience.Journal of experimental orthopaedics · 2025Article
- Medial and Patellofemoral Compartment Chondral Damage Increases With Delayed Surgical Treatment of Multiligament Knee Injuries.Orthopaedic journal of sports medicine · 2025Article
- Knee joint dislocations-Current epidemiology and treatment in Germany.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- 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 third of patients with multiligament knee injuries exhibit radiological signs of patella dislocation.Journal of experimental orthopaedics · 2025Article
- Knee-Spanning External Fixation in the Management of Knee Dislocations and Multiligamentous Knee Injuries: A Narrative Review.Open access journal of sports medicine · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposeMultiligament knee injuries (MLKIs) are devastating injuries that can have life-long consequences. A management plan requires the decision to perform surgery or not, timing of surgery, consideration of repair versus reconstruction, reconstruction technique and reconstruction graft choice. The purpose of this study was to analyze development of clinical outcomes of MLKIs over time at a minimum of 2 years of follow-up.
methodsFour databases were queried for surgical outcome-based studies of MLKIs published from 01/2000 through 09/2022 with a minimum 2-year follow-up. Technique articles, nonoperative treatment, arthroplasty, pediatric and review articles were excluded. Study characteristics including design, number of patients, age, follow-up period, anatomical region and posterior-cruciate ligament (PCL)-based injury were collected. Primary outcomes were Lysholm, International Knee Documentation Committee (IKDC) outcome scores and Tegner activity score. Random-effects model analysis was performed.
resultsAfter the application of inclusion and exclusion criteria, 3571 patients in 79 studies were included in the analysis. The mean age at surgery was 35.6 years. The mean follow-up was 4.06 years (range 2-12.7). The mean Lysholm score at 2-year follow-up was 86.09 [95% confidence interval [CI]: 82.90-89.28], with a yearly decrease of -0.80 [95% CI: -1.47 -0.13], (p = 0.0199). The mean IKDC at 2 years was 81.35 [95% CI: 76.56-86.14], with a yearly decrease of -1.99 [95% CI: -3.14 -0.84] (p < 0.001). Non-PCL-based injuries had a higher IKDC 83.69 [75.55-91.82] vs. 75.00 [70.75-79.26] (p = 0.03) and Lysholm score 90.84 [87.10-94.58] versus 84.35 [82.18-86.52] (p < 0.01) than PCL-based injuries, respectively.
conclusionAccording to the present systematic review and meta-analysis of MLKIs with minimum 2-year follow-ups, the patients who suffered an MLKI can expect to retain around 80-85% of knee function at 2 years and can expect a yearly deterioration of knee function, depending on the score used. Inferior outcomes can be expected for PCL-based injuries at 2 years postoperative. LEVEL OF EVIDENCE: Level IV meta-analysis.
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Registered trials
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