Management of multi-ligamentous knee injuries at the Nairobi Hospital

Abstract

Objective: To demonstrate the primary author’s experience in a series of three patients with multi-ligamentous knee injuries managed with 2-stage reconstruction at The Nairobi Hospital.

Methods: This study presents three patients, two with acute and one with chronic Multi Ligamentous Knee Injuries (MLKIs) who underwent staged operative treatments. These patients were managed with harvested ipsilateral bone-patella tendon-bone autografts for anterior cruciate ligament reconstruction and ipsilateral hamstring autograft for posterior cruciate ligament reconstruction where it was injured and, hamstring from the contralateral knee for posterolateral corner reconstruction, due to a lack of allografts in our setting.

Results: The surgeries are demanding and time-consuming but confidence is gained with performing them. The outcomes have been great with pain-free ambulation and resumption of common peroneal nerve function in one of the patients.

Conclusion: The lack of allografts necessitates harvesting autografts from the contralateral knee. Short-term outcomes are good. The surgeries are demanding and time-consuming but confidence is gained by performing them.