Evidence map›Paper›PMID 39949631›Full record

ArticleOrthopaedic journal of sports medicine2025

Investigating the Ligament Involvement in High-Energy and Polytraumatic Multiligament Knee Injuries Compared With Low-Energy or Isolated Injuries.

Collin D R Hunter, Joseph Featherall, Natalya McNamara, Patrick E Greis, Travis G Maak, Stephen K Aoki, Antonio Klasan, Justin J Ernat

Abstract read
In one paragraph

Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Collin D R HunterDepartment of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.ORCID https://orcid.org/0000-0001-7677-0667
Joseph FeatherallDepartment of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
Natalya McNamaraDepartment of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
Patrick E GreisDepartment of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
Travis G MaakDepartment of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.ORCID https://orcid.org/0000-0002-5023-2657
Stephen K AokiDepartment of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
Antonio KlasanAUVA UKH Steiermark, Department of Orthopaedics and Traumatology, Graz, Austria.
Justin J ErnatDepartment of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Multiligament knee injuries (MLKIs) due to high-energy (HE) or polytraumatic (PT) mechanisms result in worse patient outcomes after surgery versus low-energy (LE) or nonpolytraumatic (NPT) mechanisms. There remains a paucity of research in the literature investigating MLKIs resulting from these mechanisms of injury. Purpose: To characterize differences in ligamentous injury/surgery patterns between different mechanism groups: HE versus LE and PT versus NPT. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This is a retrospective chart review of consecutive surgical MLKIs from a single institution. Demographics, clinical/radiographic findings, and intraoperative variables were obtained. HE versus LE mechanisms were stratified. Patients with inadequate data were excluded. PT versus NPT classifications were based on presence of concurrent nonknee injuries. Subgroup comparisons were made based on body mass index, age, sex, number/type of ligaments injured, and surgeries performed. Results: From a total of 226, 176 (78%) patients were included (41 PT [23%] and 135 NPT [77%]; 62 HE [35%] and 114 LE [65%]). PT mean age was 30.7 ± 13.7 years (male, 32 [78%)], while NPT mean age was 27.1 ± 12.3 years [male, 91/135 [67%]). HE mean age was 31.4 ± 13.1 years (male, 49/62 [79%]), and LE mean age was 25.6 ± 11.8 years (male, 73/114 [64%]). Posterior cruciate ligament (PCL) injuries were higher in PT (27/41 [66%]) and HE (42/62 [68%]) versus NPT (58/135 [43%]) and LE (44/114 [39%]), respectively. Lateral collateral ligament (LCL) injuries were higher in PT (29/41 [71%]) and HE (41/62 [66%]) versus NPT (66/135 [49%]) and LE (55/114 [48%]), respectively. The mean number of ligaments injured was higher in PT versus NPT (2.9 vs 2.4) and in HE versus LE (2.8 vs 2.4). LCL surgical interventions were more common in PT (23/41 [55%]) versus NPT (49/135 [36%]) and in HE (33/62 [53%]) versus LE (39/114 [34%]). No other differences in injuries/surgeries existed between PT and NPT or HE and LE, in anterior cruciate, medial collateral, or medial patellofemoral ligaments. Conclusion: PT and HE MLKIs are characterized by increased rates of PCL and LCL injuries compared with LE and NPT. HE and PT patients experience more injured ligaments than LE and NPT and are more likely to require reconstruction/repair of the LCL. These findings suggest injury severity and mechanism may facilitate clinical decision making in MLKIs.

Indexed as

kneeknee ligamentslateral/posterior knee ligamentsmultiligament injuriesPCL

Identifiers

PMID39949631
PMCPMC11822837

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Registered trials

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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.