Functional Outcomes after Multiligament Knee Reconstruction at a Tertiary Care Hospital

Abstract

OBJECTIVES

The study aimed to determine short-term functional outcomes after multiligament knee reconstruction and identify factors associated with satisfactory recovery.

METHODOLOGY

This observational study with three-month follow-up included 142 patients aged 20-70 years with magnetic resonance imaging-confirmed injury to at least two major knee ligaments at Khyber Teaching Hospital, Peshawar, from October 2025 to April 2026. Patients underwent surgical repair and/or reconstruction according to injury pattern, followed by departmental rehabilitation. We assessed functional outcome at three months using the Lysholm knee score and categorised it as excellent, good, fair, or poor. We examined associations using chi-square or exact tests, and used binary logistic regression to identify independent predictors of excellent/good outcome.

RESULTS
Mean age was 36.17 ± 12.37 years, and 104 (73.2%) patients were male. Road traffic accidents accounted for 74 (52.1%) injuries. The mean three-month Lysholm score was 81.56 ± 11.89. Outcomes were excellent in 29 (20.4%), good in 48 (33.8%), fair in 50 (35.2%), and poor in 15 (10.6%) patients; 77 (54.2%) therefore achieved a satisfactory outcome. Functional outcome was associated with age, body mass index, timing of surgery, number of ligaments involved, and meniscal injury. Delayed surgery beyond 14 days, greater ligament involvement, increasing age, and higher body mass index independently reduced the odds of satisfactory recovery.

CONCLUSION

Multiligament knee reconstruction produced satisfactory short-term function in more than half of patients. Earlier management, careful assessment of injury complexity, weight optimisation, and structured rehabilitation may improve recovery, although longer-term multicentre evaluation is required.