Who: Joseph B. Kahan, Don Li, Christopher A. Schneble, Patrick Huang, James Bullock, Jack Porrino, Michael J. Medvecky
Overview: A team of Yale researchers closely analyzed where the specific zone of ligamentous injury occurred in a consecutive group of patients who sustained a highly uncommon knee injury where more than one major knee ligament is damaged. They categorized and developed a classification system to organize these injuries and hopefully improve future research into the non-surgical and surgical management of these be potentially limb-threatening injuries.
The researchers reviewed all patients treated for multi-ligament knee injury (MLKI) at Yale-New Haven Hospital from 2001 to 2018. Of the subgroup of patients who sustained severe injury to the outer-side ligaments, posterolateral corner injuries, known as PLC, they found that patients with very specific patterns of PLC Injury had higher incidents of peroneal nerve palsy – partial or complete muscle paralysis of the outer ankle & leg muscles, numbness, tingling, or decreased sensation.
“MLKIs with involvement of the PLC are more likely to suffer peroneal nerve injury,” they wrote. “The [Lateral Collateral Ligament] LCL is nearly always involved, and its location of injury is predictive of peroneal nerve injury. Patients with a complete peroneal nerve palsy at presentation are much less likely to regain function.”
This was the first study to so closely analyze the specific zone of injury in these uncommon knee injuries and highlights the need to establish a precise diagnosis as it can alter the treatment options and potentially the overall outcome, says Michael J. Medvecky, MD an author of the study. This study advocates for further research into this uncommon injury and assessment of outcomes based upon specific types of injuries, Medvecky says. Allowing for the most precise diagnosis may allow for an improved treatment recovery with the goal of getting both athletes and workers back to as close to their prior level of function as possible, Medvecky says.