Acute surgical management of traumatic knee dislocations — Average follow-up of 10years

Khakha, Raghbir; Day, Adrian C.; Gibbs, Jennifer L.; Allen, Steven Wayne; Hill, P.; Hull, J.B.; Perry, Arthur C.; Chissell, Hugh R.

doi:10.1016/j.knee.2015.09.019

Cited by 31 publications

(27 citation statements)

References 39 publications

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“…Very few studies underwent long-term follow-up[ 2 , 3 , 57 - 61 ] and only two studies exceeded the ten-year follow-up limit[ 3 , 59 ]. However most of these previous studies included both true dislocations and complex knee injuries together.…”

Section: Discussionmentioning

confidence: 99%

“…In some of those the operation was performed in a later stage[ 57 ], in others in an early stage[ 58 , 59 ] and some of these studies included patients, who had treatment both in early and late stage[ 58 ]. Recently, a study[ 2 ] presented good results after long-term follow-up in patients with traumatic knee dislocations. However they included patients with vascular injury requiring repair, as well as some patients with high-energy injuries.…”

Section: Discussionmentioning

confidence: 99%

“…The authors did not include patients with vascular repair but the ligament reconstruction was performed with open surgery. Recently Khakha et al[ 2 ] reported a high level of overall knee function following acute surgical reconstruction with a 10-year average follow-up. However, the treatment protocol was not consistent, since they used different grafts for PCL and PLRI reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…“Benign knee dislocation”, described by Wascher et al[ 1 ] features isolated knee injury with mild or no neurovascular compromise and intact bony structure. Controversies also exist regarding various parameters, including early vs delayed surgery, type of reconstruction technique being chosen and postoperative rehabilitation program[ 2 , 3 ]. Very few studies exist with long term follow-up, whilst most of them include cases with complex injuries and true dislocations being classified within the same category.…”

Section: Introductionmentioning

confidence: 99%

“…As far as the timing of the operation is concerned, previous studies have stress out the risk of arthofibrosis after early treatment[ 22 , 23 ]. However in other reports, there is evidence that early reconstruction, in the first 4-6 wk usually provides better results compared to delayed reconstruction[ 2 , 24 ], which could be explained by the good healing capacity of the early ruptured PCL[ 25 - 29 ]. The limit of early treatment though arbitrary is considered 3 wk.…”

Section: Introductionmentioning

confidence: 99%

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Complex knee injuries treated in acute phase: Long-term results using Ligament Augmentation and Reconstruction System artificial ligament

Gliatis¹,

Anagnostou²,

Tsoumpos³

et al. 2018

WJO

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AIMTo present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System (LARS) artificial ligament to reconstruct posterior cruciate ligament (PCL).METHODSFrom September 1997 to June 2010, thirty-eight complex knee injuries were treated, where early arthroscopic PCL reconstructions were undergone, using the LARS (Surgical Implants and Devices, Arc-sur-Tille, France) artificial ligament. Exclusion criteria were: Late (> 4 wk) reconstruction, open technique, isolated PCL reconstruction, knee degenerative disease, combined fracture or vascular injury and use of allograft or autograft for PCL reconstruction. Clinical and functional outcomes were assessed with IKDC Subjective Knee Form, KOS-ADLS questionnaire, Lysholm scale and SF-12 Health Survey. Posterior displacement (PD) was measured with the Telos Stress Device.RESULTSSeven patients were excluded; two because of co-existing knee osteoarthritis and the remaining five because of failure to attend the final follow-up. The sample consisted of 31 patients with mean age at the time of reconstruction 33.2 ± 12.5 years (range 17-61). The postoperative follow-up was on average 9.27 ± 4.27 years (range 5-18). The mean average IKDC and KOS scores were 79.32 ± 17.1 and 88.1 ± 12.47% respectively. Average PD was 3.61 ± 2.15 mm compared to 0.91 ± 1.17 mm in the uninjured knees (one with grade 1 + and two with grade 2 +). Dial test was found positive in one patient, whereas the quadriceps active drawer test was positive in three patients. None was tested positive on the reverse-pivot shift test. The range of motion (ROM) was normal in thirty knees, in comparison with the contralateral one. There was no extension deficit. Osteoarthritic changes were found in three knees (9.6%).CONCLUSIONEarly treatment of complex knee injuries, using LARS artificial ligament for PCL reconstruction sufficiently reduces posterior tibia displacement and provides satisfactory long-term functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Complex knee injuries treated in acute phase: Long-term results using Ligament Augmentation and Reconstruction System artificial ligament

Gliatis¹,

Anagnostou²,

Tsoumpos³

et al. 2018

WJO

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Outcomes after multiligament knee injury worsen over time: A systematic review and meta‐analysis

Klasan,

Maerz,

Putnis

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeMultiligament knee injuries (MLKIs) are devastating injuries that can have life‐long consequences. A management plan requires the decision to perform surgery or not, timing of surgery, consideration of repair versus reconstruction, reconstruction technique and reconstruction graft choice. The purpose of this study was to analyze development of clinical outcomes of MLKIs over time at a minimum of 2 years of follow‐up.MethodsFour databases were queried for surgical outcome‐based studies of MLKIs published from 01/2000 through 09/2022 with a minimum 2‐year follow‐up. Technique articles, nonoperative treatment, arthroplasty, pediatric and review articles were excluded. Study characteristics including design, number of patients, age, follow‐up period, anatomical region and posterior‐cruciate ligament (PCL)‐based injury were collected. Primary outcomes were Lysholm, International Knee Documentation Committee (IKDC) outcome scores and Tegner activity score. Random‐effects model analysis was performed.ResultsAfter the application of inclusion and exclusion criteria, 3571 patients in 79 studies were included in the analysis. The mean age at surgery was 35.6 years. The mean follow‐up was 4.06 years (range 2–12.7). The mean Lysholm score at 2‐year follow‐up was 86.09 [95% confidence interval [CI]: 82.90–89.28], with a yearly decrease of −0.80 [95% CI: −1.47 −0.13], (p = 0.0199). The mean IKDC at 2 years was 81.35 [95% CI: 76.56–86.14], with a yearly decrease of −1.99 [95% CI: −3.14 −0.84] (p < 0.001). Non‐PCL‐based injuries had a higher IKDC 83.69 [75.55–91.82] vs. 75.00 [70.75–79.26] (p = 0.03) and Lysholm score 90.84 [87.10–94.58] versus 84.35 [82.18–86.52] (p < 0.01) than PCL‐based injuries, respectively.ConclusionAccording to the present systematic review and meta‐analysis of MLKIs with minimum 2‐year follow‐ups, the patients who suffered an MLKI can expect to retain around 80‐85% of knee function at 2 years and can expect a yearly deterioration of knee function, depending on the score used. Inferior outcomes can be expected for PCL‐based injuries at 2 years postoperative.Level of EvidenceLevel IV meta‐analysis.

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Multiple-Ligament Knee Injuries in the United States Military Active-Duty Population

Pallis

LanziJr.

Garcia

et al. 2019

The Multiple Ligament Injured Knee

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Acute surgical management of traumatic knee dislocations — Average follow-up of 10years

Cited by 31 publications

References 39 publications

Complex knee injuries treated in acute phase: Long-term results using Ligament Augmentation and Reconstruction System artificial ligament

Complex knee injuries treated in acute phase: Long-term results using Ligament Augmentation and Reconstruction System artificial ligament

Outcomes after multiligament knee injury worsen over time: A systematic review and meta‐analysis

Multiple-Ligament Knee Injuries in the United States Military Active-Duty Population

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