Postoperative Rehabilitation After Multiligament Knee Reconstruction

Multiligament knee injuries (MLKI) can be disabling and may be challenging to manage due to the multiple structures involved. Surgical intervention is generally indicated to treat this complex pathology as MLKI cases do not return to normal function with conservative intervention alone. Anatomic reconstruction can help to restore joint stability which is complemented with postoperative rehabilitation to further maximize knee function. Postoperative recovery may be extended compared to other single ligament procedures and typically involves more robust precautions; however, individuals recovering from multiligament knee reconstruction (MLKR) will have similar goals with respect to joint protection and symptom control and the gradual recovery of motion, strength, load capacity, cardiovascular fitness, and higher-level function, especially in individuals looking to return to sport (RTS). There is limited literature reporting on the standardized postoperative physical therapy (PT) management of MLKR specific to precautions, rehabilitation protocols, and objective testing for RTS which may contribute to increased challenge or confusion for the treating clinician. This chapter describes the epidemiology of MLKI and the existing knowledge specific to postoperative rehabilitation and outcomes following MLKR to provide clinicians with key concepts to guide postoperative care and ensure a full recovery for patients.