2024 AOSSM Annual Meeting Recordings no CME-Concurrent D: ESSKA: Therapeutic Challenges in Multi-Ligament Injured Knees

Video Transcription

Video Summary

The ESCA session focused on the complex management of multiligament knee injuries, featuring presentations from experts Michael Hantes, David de Jure, Berthe Boer, and Stefano Zaffanini. The session's topics ranged from surgical planning and anatomical considerations to the timing of surgical intervention.<br /><br />David de Jure discussed surgical planning, emphasizing the need for accurate diagnosis and classification to guide treatment decisions. He highlighted the severity of injuries involving two or more major knee ligaments and the need for careful assessment of potential vascular and nerve damage.<br /><br />Berthe Boer addressed the management of the posterolateral corner, elaborating on the anatomy and importance of the structures involved, such as the lateral collateral ligament, popliteus tendon, and popliteofibular ligament. She stressed the critical nature of recognizing and addressing nerve injuries, which are common in lateral-sided knee injuries, and recommended early surgery for better outcomes.<br /><br />Michael Hantes spoke on managing medial-sided knee injuries, explaining the roles of the superficial MCL, deep MCL, and posterior oblique ligament. He outlined indications for acute surgical intervention, such as tibial-sided avulsion injuries and MCL entrapment within the joint, advocating for staged reconstruction to minimize the risk of stiffness.<br /><br />Stefano Zaffanini discussed early versus delayed management of multiligament knee injuries, considering factors influencing outcomes, including age, BMI, the severity of trauma, and the presence of dislocations. He presented literature suggesting no significant difference in outcomes between early and delayed surgeries but noted higher complication rates with delayed treatment.<br /><br />The session concluded with a Q&A, where the panelists discussed preferences for graft selection, indications for using external fixators, and strategies to prevent postoperative stiffness, underscoring the tailored approach required for these complex injuries.

Asset Caption

2:25 pm - 3:25 pm

Meta Tag

Speaker Michael Hantes, MD

Speaker Romain Seil, MD, PhD

Speaker Berte Boe, MD, PhD

Speaker Stefano Zaffagnini, MD

Keywords

multiligament knee injuries

surgical planning

anatomical considerations

vascular damage

nerve damage

posterolateral corner

medial-sided knee injuries

early surgery

delayed management

postoperative stiffness

Michael Hantes, MD

Romain Seil, MD, PhD

Berte Boe, MD, PhD

Stefano Zaffagnini, MD