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However, although this may be associated with the severity of injury, recent research has shown that patients who undergo external fixation at index surgery and\/or who have vascular injury are at increased risk of requiring manipulation under anesthesia. This finding is clinically significant in that it is reassuring that stiffness requiring manipulation is no more likely to develop in obese patients than in non\u2010obese patients after MLKI reconstruction. I have often believed that controlled arthrofibrosis can be somewhat beneficial in the management of MLKI and have advised patients over the years that a required manipulation in this case is not really a complication but more of a continuation of care. Stiffness after an MLKI surgical procedure is preferable to recurrent instability.<\/jats:p>","DOI":"10.1016\/j.arthro.2022.08.012","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T04:41:14Z","timestamp":1669783274000},"page":"3182-3183","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Editorial Commentary:<\/i>\n                    External Fixation and\/or Vascular Injury Is Associated With Postoperative Arthrofibrosis After Multiple\u2010Ligament Knee Injury Reconstruction"],"prefix":"10.1002","volume":"38","author":[{"suffix":"III","given":"Claude T.","family":"Moorman","sequence":"first","affiliation":[{"name":"Charlotte North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000075346.05460.D6"},{"key":"e_1_2_2_3_2","first-page":"343","article-title":"Nerve injury complicating multiligament knee injury: Current concepts and treatment algorithm","volume":"21","author":"Mock W.R.","year":"2013","journal-title":"J\u00a0Am Acad Orthop Surg"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504271208"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3719-0"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.06.017"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806322004893?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806322004893?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2022.08.012","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2022.08.012","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2022.08.012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:20:41Z","timestamp":1773566441000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2022.08.012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":5,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1016\/j.arthro.2022.08.012"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2022.08.012","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Editorial Commentary: External Fixation and\/or Vascular Injury Is Associated With Postoperative Arthrofibrosis After Multiple-Ligament Knee Injury Reconstruction","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2022.08.012","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}