What is a Multi-Ligament Injury?

Five major structures work together to stabilize the knee joint (four major ligaments and a complex called the posterolateral corner). These ligaments include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), the lateral collateral ligament (LCL or FCL) and the posterolateral corner. If two or more of these ligaments are injured, it is considered a multi-ligament injury and is a complex type of knee injury. Multi-ligament injuries most often occur from a traumatic event such as a skiing injury, automobile accident, sports fall or a blow to the knee. Complex knee surgeon, Dr. Armando Vidal, has specialized training and experience when dealing with multi-ligament injuries. It is important that patients in Vail, Aspen and the surrounding Denver, Colorado communities seek out his expertise for the best possible outcome from their complex knee injuries.

Can you tear all the ligaments in the knee?

In a word, yes. However, it is rare to tear all four ligaments in the knee at one time. Dr. Vidal sees injuries of this type from a serious automobile accident, hard crash on snow skis or a severe tackle in football.

How is a multi-ligament injury diagnosed?

Since multi-ligament injuries usually involve trauma, several diagnostic tests are necessary to make the diagnosis. X-rays will show Dr. Vidal any related bone damage and an MRI will show soft tissue damage. Stress x-rays are often necessary to determine if a ligament is intact or compromised. Dr. Vidal will also do a thorough exam of the injured knee as well as a history of events that caused the ligament damage.

What is done to fix a complex knee injury?

Multi-ligament knee reconstruction surgery for patients in Aspen, Vail and the surrounding Denver Colorado communities is a very individualized process. Dr. Vidal will assess the specific pattern of injury and discuss with you the required reconstruction and expected outcome.

It is not unusual for some of the ligaments to be left to heal on their own if their damage is minimal. Completely torn or damaged ligaments will be repaired/reconstructed in one surgery. Dr. Vidal may use a combination of arthroscopic and open surgery techniques which require multiple incisions for this complex procedure. In general, a multi-ligament knee reconstruction involves removing the damaged portions of the ligament and placing a graft in the exact location of the original ligament. The graft may be from the patient’s own tissue (called an autograft) or it could be from donated tissue from a cadaver, (called an allograft). Severe tears may require multiple grafts.

What happens after complex knee surgery?

How long is the recovery?

Every surgery and injury is different.  Multi-ligament injuries are by definition, complex, and often have associated fractures, meniscal injury or cartilage injuries.  These associated injuries can and will influence the postoperative recovery.

In general, rehabilitation following multi-ligament surgery begins immediately. Most patients are non-weight bearing in brace for the first 6 weeks depending on what ligaments are reconstructed and what other associated procedures are performed.  It is important that patients full knee extension as soon as possible. Physical therapy will work on quadriceps activation as well as edema control. Dr. Vidal likes to see 90 percent flexion within the first two weeks. Further motion is obtained the first six weeks at which time the patient may begin putting weight on the knee.

Full recovery after this type of serious procedure can take 9-12 months of post-operative rehabilitation. It is important to continue with the rehabilitation protocol prescribed by Dr. Vidal in order to have the best possible outcome.

Complex Knee Surgeon

The knee is a very complicated section of anatomy with four different crucial ligaments. Although it is rare to break all four ligaments at once, it is relatively common to damage more than one ligament. Complex knee surgeon, Doctor Armando Vidal has much experience diagnosing and treating patients in Vail, Aspen, and the surrounding Denver, Colorado communities who have experienced a knee injury affecting more than one ligament. Contact Dr. Vidal’s team today!


The Steadman Clinic – Vail, CO
180 S Frontage Rd W
Vail, CO 81657

The Steadman Clinic – Frisco, CO
226 Lusher Court
Ste 101
Frisco, CO 80443

The Steadman Clinic – Edwards, CO
322 Beard Creek Road
Edwards, CO 81632


Office Hours
Monday-Friday: 8:00am – 5:00pm

Mailing Address
181 Meadow Dr, Suite 400
Vail, CO 81657

970-401-8940 Direct
970-476-1100 General Appointment Scheduling