Combined anterior and posterior cruciate ligament injuries: The multiple-ligament-injured knee

The multiple-ligament-injured knee is a complex problem in orthopaedic surgery. It may present as an acute knee dislocation and careful assessment of the extremity's vascular status is essential because of the possibility of arterial and/or venous compromise. These injuries require a systematic approach to evaluation and treatment. Physical examination and imaging studies enable the surgeon to make a correct diagnosis and formulate a treatment plan. Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction is a reproducible procedure. Postoperative knee stability is improved when evaluated with knee-ligament rating scales, arthrometer testing, and stress radiographic analysis. The timing of surgery depends on the injured ligaments, vascular status of the extremity, reduction stability, and overall health of the patient. Allograft tissue is preferred because these large grafts are strong and yield no donor site morbidity.