Selected Instructional Course Lecture   |    
Management of Complex Knee Ligament Injuries
Gregory C. Fanelli, MD1; James P. Stannard, MD2; Michael J. Stuart, MD3; Peter B. MacDonald, MD4; Robert G. Marx, MD, MSc, FRCSC5; Daniel B. Whelan, MD6; Joel L. Boyd, MD7; Bruce A. Levy, MD3
1 Department of Orthopaedic Surgery, Geisinger Medical Center, 115 Woodbine Lane, Danville, PA 17822-5212
2 Department of Orthopaedic Surgery, University of Missouri, 1 Hospital Drive, Columbia, MO 65212
3 Department of Orthopedic Surgery (M.J.S. and B.A.L.) and Sports Medicine Center (M.J.S.), Mayo Clinic, 200 First Avenue S.W., Rochester, MN 55906
4 Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB R3M 3E4, Canada
5 Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
6 University of Toronto, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada
7 TRIA Orthopaedic Center, 8100 Northland Drive, Minneapolis, MN 55431
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits of less than $10,000 or a commitment or agreement to provide such benefits from commercial entities (Biomet and Arthrex).

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in February 2011 in Instructional Course Lectures, Volume 60. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

Copyright © 2010 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Sep 15;92(12):2235-2246
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


Initial evaluation of a knee with multiple ligament injuries begins with a thorough and complete neurovascular examination, an assessment of the soft tissue, and determination of the instability pattern. Failure to recognize a vascular injury can lead to catastrophic limb dysfunction and ultimately to amputation. Injury to the tibial and/or peroneal nerves can also have devastating consequences and is encountered in almost 25% of dislocated knees1. The modified Schenck classification2, in which not only ligamentous structures but also neurovascular injury and the presence of periarticular fracture are taken into account, is widely used to describe these injuries.
Figures in this Article

    First Page Preview

    View Large
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    Ohio - OhioHealth Research and Innovation Institute (OHRI)
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    Oregon - The Center - Orthopedic and Neurosurgical Care and Research