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Abstract
Objective To map the current literature evaluating the diagnosis and treatment of multiligament knee injuries (MLKIs).
Design Scoping review.
Data sources Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and Arksey and O’Malley frameworks were followed. A three-step search strategy identified relevant published literature comprising studies reporting on at least one aspect in the diagnosis or treatment of MLKI in adults. Data were synthesised to form a descriptive analysis and thematic summary.
Results Overall, 417 studies were included. There was a substantial chronological increase in the number of studies published per year, with 70% published in the last 12 years. Of included studies, 128 (31%) were narrative reviews, editorials or technical notes with no original data. The majority of studies (n=239, 57%) originated from the USA; only 4 studies (1%) were of level I evidence. Consistent themes of contention included clinical assessment, imaging, operative strategy, timing of surgery and rehabilitation. There was a lack of gender and ethnic diversity reported within patient groups.
Conclusions There remains insufficient high-level evidence to support definitive management strategies for MLKI. There is considerable heterogeneity in outcome reporting in current MLKI literature, precluding robust comparison, interpretation and pooling of data. Further research priorities include the development of expert consensus relating to the investigation, surgical management and rehabilitation of MLKI. There is a need for minimum reporting standards for clinical studies evaluating MLKI.
- knee
- sports
- rupture
- ligaments
- diagnosis
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
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Footnotes
Twitter @makortho, @MurraySportOrth, @GilbertMoatshe
Contributors NM: Conceptualisation, methodology, formal analysis, data curation, writing—original draft, writing—review and editing, IRM: Conceptualisation, methodology, formal analysis, data curation, writing—original draft, writing—review and editing, AG: writing—review and editing, JC: writing—review and editing, GM: writing—review and editing, RFL: Conceptualisation, writing—review and editing, supervision and guarantor. All authors contributed to the planning, conduct and reporting of the work described in this article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Competing interests IRM reports the following disclosures:Arthrex: Paid consultant, Bone and Joint Research: Editorial or governing board, Journal of Bone and Joint Surgery—British: Editorial or governing board, Stryker: Paid consultant. AG reports the following disclosures: American Orthopaedic Society for Sports Medicine: Board or committee member, Arthroscopy: Editorial or governing board, Infographics Editor, Ossur: Paid presenter or speaker, Smith and Nephew: Paid consultant; Paid presenter or speaker. JC reports the following disclosures: American Orthopaedic Society for Sports Medicine: Board or committee member, Arthrex: Paid consultant, Arthroscopy Association of North America: Board or committee member, CONMED Linvatec: Paid consultant, International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member, Ossur: Paid consultant, Smith & Nephew: Paid consultant. GM reports the following disclosures: Smith & Nephew: Paid consultant. RFL reports the following disclosures: American Journal of Sports Medicine: Editorial or governing board, American Orthopaedic Society for Sports Medicine: Board or committee member, Arthrex: IP royalties; Research support, International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member, Journal of Experimental Orthopaedics: Editorial or governing board, Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board, Linvatec: Research support, Ossur: IP royalties; Paid consultant; Research support, Smith & Nephew: IP royalties; Paid consultant; Research support.
Provenance and peer review Not commissioned; externally peer reviewed.
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