Ligament repair and reconstruction in traumatic dislocation of the knee

Abstract

e treated 21 patients with 22 dislocations of the knee by repair or reconstruction of all injured ligaments. Eight knees were treated in the acute phase (less than two weeks after injury); the remainder were treated more than six months after injury (6 to 72). Reconstructions were carried out with a combination of autograft and allograft tendons and by direct ligament repair where possible. At a mean follow-up of 32 months (11 to 77) the mean Lysholm score was 87 (81 to 91) in the acute group and 75 (53 to 100) in the delayed group. The mean Tegner activity rating was 5 in the acute group and 4.4 in the delayed group.The International Knee Documentation Committee assessment revealed no differences between the two groups. Instrumented testing of knee stability indicated better results for anterior cruciate ligament reconstructions which had been undertaken in the acute phase, but no difference in the outcome of posterior cruciate ligament reconstructions. There was no difference in the loss of knee movement between the two groups. Although the differences were small, the outcome in terms of overall knee function, activity levels and anterior tibial translation were better in those knees which had been reconstructed within two weeks of injury.J Bone Joint Surg [Br] 2003;85-B:845-51.

Surgical Technique: Articulated External Fixator for Treatment of Complex Knee Dislocation

“…Those authors concluded staged reconstruction minimized postoperative stiffness. Their results confirmed the risk of arthrofibrosis and stiffness was higher when both cruciate ligaments were reconstructed at the same time [6,7,16,17,29,30]. This aspect was even more important when associated lesions, such as neurovascular injuries, or fractures occurred.…”

Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

“…Existing knee dislocation studies focus on surgical treatment of the ligamentous injuries [1,8,[17][18][19]30], but the impact of associated injuries such as those to the popliteal artery or peroneal nerve can be just as vital. In this study, we evaluated motor and sensory recovery as well as patient-reported outcomes scores in patients with peroneal nerve injury after knee dislocation, compared recovery between partial and complete palsies, and established the impact of peroneal nerve injury by contrasting results with a cohort of patients without nerve injury.…”

Evaluation of reconstructive surgery using artificial ligaments in 71 acute knee dislocations

“…The introduction of surgical treatment was later shown to be more effective than conservative treatment [2,3]. It began with the primary repair of the injured ligaments [4][5][6], then evolved into the era of reconstruction [7][8][9][10][11][12][13][14][15][16][17][18]. Surgical reconstruction is now the standard of care for most patients, although good results were recently achieved with repair [4].…”