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This volume of Grand Rounds from HSS focuses on the management of severe knee injuries. Three cases highlighting the importance of recognizing all clinically significant pathology encountered with knee injury, and the combination of complex reconstructive procedures necessary to restore comfort and the possibility of durable knee function.

 In the first case, Scott Rodeo, MD, describes his two-stage management of a 51-year-old female with compromising connective tissue laxity and an unstable knee after failed anterior cruciate ligament reconstruction. Effectively restoring knee function required much more than anterior cruciate ligament reconstruction and is achieved by understanding and sequentially addressing the combination of bone and soft tissue deficiencies necessary to effectively establish a stable knee.

Case two involves a young, powerful elite athlete. Robert Marx, MD, and Aaron Daluiski, MD,enable this motivated athlete, devastated by a knee dislocation resulting in multi-ligament and peroneal nerve injury, to not only recover knee stability and nerve function but to realize his ambitions to perform at a high level in college baseball.

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