Dislocation of the knee

Background The multiple-ligament-injured knee represents a special challenge, being an uncommon injury that is both severe and complicated to treat. Many studies have evaluated patients treated for this injury, but most are limited in their scope. The evaluation of this injury and its treatment using an administrative database might provide a different perspective.Questions/purposes Using a large administrative database, we determined (1) the number of multiligament knee reconstructions in New York State, (2) the rate of 90-day hospital readmission, and (3) the frequency of subsequent knee surgery. We examined the rates of these outcomes as a function of diagnosis, admission type, discharge status, comorbidity burden, and patient demographic factors. Methods We used the New York Department of Health Statewide Planning and Research Cooperative System (SPARCS), a database with information on patient characteristics, diagnoses, and treatments, to identify patients who underwent a multiligament procedure in a nonfederal facility from 1997 to 2005 using ICD-9-CM and Current Procedural Terminology codes. SPARCS collects data from all nonfederal acute care facilities, with an estimated reporting completeness of almost 99% for the years in this study. We evaluated data on patient age, sex, admission type, discharge status, and comorbidity burden (using Elixhauser comorbidities) and developed a multivariable logistic regression model to assess the influence of confounding variables. Results We identified 1032 patients in this database who underwent multiligament knee reconstruction in New York State from 1997 to 2005. The frequency of readmission within 90 days was 4.8% (n = 49). Readmission was more likely for patients who underwent inpatient multiligament reconstruction (odds ratio [OR] = 2.3; 95% CI: 1.2-4.4; p = 0.014), had a diagnosis of dislocation (OR = 2.2; 95% CI: 1.2-3.9; p = 0.011), or had various Elixhauser comorbidities, including chronic lung disease (OR = 6.4; 95% CI: 1.5-27.2; p = 0.013), fluid and electrolyte disorders (OR = 19.7; 95% CI: 2.5-155.7; p = 0.005), and anemia deficiency (OR = 5.6; 95% CI: 1.05-29.4; p = 0.044). Two hundred eighty-seven patients (28%) underwent subsequent knee surgery between their index

Section: Introductionmentioning

confidence: 99%

Epidemiology of Multiligament Knee Reconstruction

Wilson

Mehta

Hương

et al. 2014

“…Dislocation of the knee is a rare injury and accounts for 0.02% to 0.2% of orthopaedic injuries [12,19,20]. The cause of injury can be high-or low-energy trauma [3].…”

Section: Introductionmentioning

confidence: 99%

Posterior Tibial Tendon Transfer Improves Function for Foot Drop After Knee Dislocation

Molund

Engebretsen

Hvaal

et al. 2014

“…The peroneal nerve, often ruptured in knee dislocations, can sustain an injury from its proximal origin high in the popliteal fossa to several centimeters distal to the fibular head, a distance spanning greater than 15 cm [1,16]. The common peroneal nerve injury results in loss of sensation to the dorsum of the foot and gait-altering paralysis of the tibialis anterior and the peroneus muscles.…”

Section: Introductionmentioning

confidence: 99%

Partial Tibial Nerve Transfer to the Tibialis Anterior Motor Branch to Treat Peroneal Nerve Injury After Knee Trauma

Giuffre

Bishop

Spinner

et al. 2012

106

Background Injuries to the deep peroneal nerve result in tibialis anterior muscle paralysis and associated loss of ankle dorsiflexion. Nerve grafting of peroneal nerve injuries has led to poor function; therefore, tendon transfers and anklefoot orthotics have been the standard treatment for foot drop. Questions/purposes We (1) describe an alternative surgical technique to obtain ankle dorsiflexion by partial tibial nerve transfer to the motor branch of the tibialis anterior muscle; (2) evaluate ankle dorsiflexion strength using British Medical Research Council grading after nerve transfer; and (3) qualitatively determine factors that influence functional success of surgery. Methods We retrospectively reviewed 11 patients treated with partial tibial nerve transfers after peroneal nerve injury. Pre-and postoperative motor strength was measured. Patients completed questionnaires regarding preand postoperative gait and disability.