{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:07:21Z","timestamp":1787018841050,"version":"build-2736575974"},"reference-count":49,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Multiligament knee injuries (MLKIs) are heterogeneous, and bicruciate knee ligament injuries are considered a serious form of this injury. The current literature tends not to distinguish between single and bicruciate MLKI when reporting outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate patient-reported outcomes after surgical treatment of MLKI comparing single cruciate MLKI with bicruciate MLKI. The secondary aim was to investigate the influence of different factors on patient-reported outcomes after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study was designed as a cross-sectional cohort study. Patients who underwent surgical treatment for MLKI at a single level 1 trauma center between January 2013 and December 2020 were included in this study. Patient-reported outcomes included the Tegner score, Lysholm score, International Knee Documentation Committee (IKDC) subjective knee form, Knee injury and Osteoarthritis Outcome Survey (KOOS), and a visual analog scale for pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 191 patients meeting the inclusion criteria, 124 (65%) agreed to participate and had a complete data set with a follow-up time at a mean 74 \u00b1 27 months. Patients with single cruciate MLKI (type I) had significantly higher scores for IKDC (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007), Lysholm (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .012), KOOS Pain (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04), KOOS Activities of Daily Living (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01), KOOS Sport and Recreation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005), KOOS Quality of Life (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04), KOOS\n                      <jats:sub>4<\/jats:sub>\n                      (which considers the subscales of Pain, Symptoms, Sport and Recreation, and Quality of Life) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01), Tegner (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04), and visual analog scale for pain during activity (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004) when compared with patients with bicruciate MLKI (type II-type IV). Furthermore, age was significantly associated with a lower IKDC (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001), and an increased severity of injury was significantly associated with IKDC (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .015), KOOS\n                      <jats:sub>4<\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .022), and Lysholm (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .029) scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MLKIs involving a single cruciate ligament had significantly higher patient-reported postoperative outcome measures compared with bicruciate MLKIs. Age and type of injury were important predictors for outcomes. Patients presenting with dislocated knees had lower patient-reported outcomes; however, there was no significant difference in outcomes between bicruciate MLKIs and patients presenting with dislocated knees.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241293743","type":"journal-article","created":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T04:02:11Z","timestamp":1735704131000},"page":"138-146","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Patient-Reported Outcomes of Bicruciate Multiligament Versus Single Cruciate Multiligament Knee Injuries"],"prefix":"10.1177","volume":"53","author":[{"given":"Ingrid","family":"Tr\u00f8an","sequence":"first","affiliation":[{"name":"Orthopaedic Division, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tone","family":"Bere","sequence":"additional","affiliation":[{"name":"Orthopaedic Division, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Holm","sequence":"additional","affiliation":[{"name":"University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"LaPrade","sequence":"additional","affiliation":[{"name":"Twin Cities Orthopedics, Edina, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2294-921X","authenticated-orcid":false,"given":"Lars","family":"Engebretsen","sequence":"additional","affiliation":[{"name":"University of Oslo, Oslo, Norway"},{"name":"Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Moatshe","sequence":"additional","affiliation":[{"name":"Orthopaedic Division, Oslo University Hospital, Oslo, Norway"},{"name":"University of Oslo, Oslo, Norway"},{"name":"Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway"},{"name":"Department of Experimental Orthopaedic Research, Institute for Surgical Research, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511414855"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2162-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2021.08.036"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06926-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-106099"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520962088"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0869-y"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(96)90213-3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907797"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2154-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-2925-5"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231168892"},{"key":"e_1_3_3_14_2","unstructured":"Hansen B. 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