What are the risks of multi-ligament knee reconstruction?

Stiffness

Stiffness, sometimes called arthrofibrosis, is the commonest problem after multi-ligament surgery, because the original injury and the surgery both cause scarring. Early, guided movement is the main defence. If bending or straightening stalls despite physiotherapy, a manipulation under anaesthesia or an arthroscopic release of scar tissue is sometimes needed.

Residual laxity and graft problems

Some knees remain slightly loose in one direction after surgery. This often does not affect daily life, but a significant graft stretch or failure may need further surgery. Recognising every injured structure, especially the posterolateral corner, and correcting malalignment when present help reduce this risk.

Other risks

• Wound healing problems and infection, more likely when skin was bruised or swollen at the time of surgery
• Deep vein thrombosis and, rarely, clots travelling to the lungs, reduced with early movement and preventive medication when indicated
• Injury to the peroneal nerve or popliteal vessels, which run close to the operative field and are identified and protected
• Numbness around the incisions, which is common and usually improves
• Pain and swelling that take many months to settle
• Later osteoarthritis, linked to the original injury and to any cartilage or meniscus damage

Discussing risk before surgery

Your personal risk depends on the injury, your general health, smoking, body weight and whether there were nerve or artery injuries. At Aman Hospital in Doha, Dr. Gelber goes through these factors, explains what is realistic for your knee and what you can do to help, such as stopping smoking and committing to rehabilitation. Seek urgent review after surgery for fever, increasing wound redness or discharge, calf swelling or chest pain and breathlessness.