Abstract
OBJECTIVES: We report on the recovery of strength and functional capacity symmetry following multi-ligament knee surgical reconstruction (MLKR) in a cohort of mostly athletes, as well as the capacity to return to sport. METHODS: This prospective cohort study recruited 47 patients undergoing MLKR between February 2018 and July 2021. Forty patients had full outcome assessment post-operatively at 6-, 12- and 24-months and were included in the analysis, 77.5% were Knee Dislocation (KD) 1 injuries and 60% were injured playing sport. Patient Reported Outcome Measures (PROMs) assessed included the International Knee Documentation Committee (IKDC) score, the Knee Outcome Survey (KOS), the Lysholm Knee Score (LKS), and the Tegner Activity Scale (TAS). Patient satisfaction was also assessed. Objective assessment included assessment of active knee flexion and extension range of motion (ROM), the single (SHD) and triple (THD) hop tests for distance, and peak isokinetic knee flexor/extensor torque. RESULTS: All PROMs significantly improved (p<0.001) from pre-surgery to 24 months post-surgery. At 24 months, 70% of patients were satisfied with their sports participation. Active knee flexion (p<0.0001) and extension (p<0.0001) ROM significantly improved over time, as did the limb symmetry indices (LSIs) for the SHD (p<0.0001), THD (p<0.0001), peak knee extensor (p<0.0001) and flexor (p=0.012) torque. While LSIs for the SHD, THD and knee flexor strength tended to plateau by 12 months, knee extensor strength continued to improve from 12 to 24 months. CONCLUSION: The majority of patients undergoing modern MLKR surgical techniques and rehabilitation can achieve excellent knee function at 2 years, with low complication rates and high rates of return to sport.