How to avoid tunnel convergence in a multiligament injured knee

Multiligament knee injuries are challenging to diagnose and treat. For knee dislocations surgical treatment of the torn ligaments has been demonstrated to be superior to non-operative management. Furthermore, reconstruction of the torn ligaments has been demonstrated to be superior to repair of the torn ligaments. Repair of knee ligaments is associated with higher failure and reoperation rates compared to reconstruction; therefore, anatomic reconstruction of the torn ligaments is recommended. It is imperative to perform anatomic reconstructions to restore both the anatomy and the biomechanics of the knee. When reconstructing several knee ligaments, there is a risk of tunnel confluence in both the femur and the tibia. Prior to and during surgery, thorough planning of tunnel placement and orientation is important.