Results after Treatment of Traumatic Knee Dislocations: A Report of 26 Cases

Rı́os, Antonio; Villa, Ángel; Fahandezh, Homid; José, C. de; Vaquero, Javier

doi:10.1097/01.ta.0000043921.09208.76

Cited by 115 publications

(39 citation statements)

References 17 publications

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“…Decreased ability to flex the knee <110° was present in 4 patients. Seven patients (10%) underwent an arthroscopic arthrolysis during follow-up, which is consistent with the literature[20,27,31]. …”

Section: Discussionsupporting

confidence: 90%

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Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

Hirschmann

Zimmermann

Rychen

et al. 2010

BMC Musculoskelet Disord

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BackgroundThe purpose of our study was to analyze the clinical and radiological long-term outcomes of surgically treated traumatic knee dislocations and determine prognostic factors for outcome.MethodsRetrospective consecutive series of patients treated surgically for traumatic knee dislocation with reconstruction/refixation of the anterior (ACL) and posterior cruciate ligaments (PCL) and primary complete repair of collaterals and posteromedial and posteromedial corner structures. 68 patients were evaluated clinically (IKDC score, SF36 health survey, Lysholm score, Knee Society score, Tegner score, visual analogue scale - VAS pain and satisfaction, Cooper test) and radiologically (weight bearing and stress radiographs) with a mean follow up of 12 ± 8 years. Instrumented anterior-posterior translation was measured (Rolimeter, KT-1000). Pearson correlation and stepwise regression analysis was used.Results82% of patients (n = 56) returned to their previous work. At final follow-up 6 patients (9%) suffered from pain VAS > 3. The mean side-to-side difference of anterior/posterior translation (KT-1000, 134N) was 1.6 ± 1.6 mm and 2.6 ± 1.4 mm. Valgus and varus stress testing in 30° flexion was <3 mm (normal) in 57 patients (86%). The IKDC score was normal/nearly normal in 38 (58%) patients and the mean Lysholm score 83 ± 17 (intact 98 ± 7). The median Tegner score decreased from 7 preinjury (range 3-10) to 5 at follow-up (range 0-10). The mean Knee Society score was 187 ± 15 (out of maximum 200). In 7 patients (10%) a secondary ligament reconstruction was performed. Three patients (4%) underwent a high tibial osteotomy and four (6%) received a primary unconstrained total knee replacement. According to the Kellgren Lawrence osteoarthritis score only mild degenerative changes were present. The stress radiographs showed stable results for anteroposterior translation. Injury of the lateral collateral ligament, refixation of the ACL/PCL and delayed surgery >40 days were significantly associated with worse outcome (p < 0.05).ConclusionsEarly complete reconstruction can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity. Negative predictive factors for outcome were injury pattern, type of surgical procedure and timing of surgery.

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Section: Discussionsupporting

confidence: 90%

“…Most authors agree that non-surgical treatment with cast immobilization produces inferior results compared to surgical treatment regimens [5,17,29,43]. A variety of surgical procedures both open[8,21,27,29,31,44] and arthroscopy-assisted[19,21] have been reported.…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

Hirschmann

Zimmermann

Rychen

et al. 2010

BMC Musculoskelet Disord

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“…Finally, regarding the Meyers rating, 39 of 45 patients (86.7%) had excellent or good scores. This result is also within range of published data for Meyers rating, which range from 74.2% to 87.8% [5,[10][11][12] for excellent or good scores. When comparing the results of high-vs. low-energy dislocations and KD II/III vs. KD IV injuries, we found a better Lysholm score for the KD II/III group.…”

Section: Discussionsupporting

confidence: 78%

“…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].…”

Section: Introductionmentioning

confidence: 99%

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

Ranger

Renaud

Phan

et al. 2010

International Orthopaedics (SICOT)

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This retrospective study assessed the results of 71 patients with knee dislocations who underwent acute combined repair and reconstruction using Ligament Advancement Reinforcement System (LARS) artificial ligaments between June 1996 and May 2008 with a follow-up between two and eight years. The outcome measures used were the Lysholm score, the International Knee Documentation Committee form (IKDC 2000), the Tegner activity level score, the Meyers ratings, Telos stress radiography, range of motion and clinical knee stability testing. When comparing high-versus low-energy dislocations and knee dislocation (KD) II/III versus KD IV injuries, a better Lysholm score for the knee dislocation (KD) II/III group was found compared with the KD IV group. The subjective and objective findings from our study are satisfactory and comparable with the results of other studies of knee dislocations. Our findings suggest that with a mean follow-up of 54 months, acute combined repair and reconstruction with LARS ligaments is a valid alternative for treating knee dislocations.

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“…Levy et al performed a systematic review of all studies comparing operative and non-operative treatment of MKIs up to August 2007 [2]. This review included three retrospective cohort analyses [7-9] and a meta-analysis of studies performed up to the year 2000 [10]. Levy et al ’s systematic review amalgamated data from these four studies and found that patients receiving operative treatment returned to work earlier than those that where managed non-operatively (72% versus 52%) [2].…”

Section: Surgical Repair Versus Conservative Managementmentioning

confidence: 99%

State of the Art Regarding the Management of Multiligamentous Injuries of the Knee

Mabvuure¹,

Malahias²,

Haddad³

et al. 2014

TOORTHJ

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Multiligamentous knee injuries are rare but serious injuries that can threaten limb viability. As such, they require careful management to give patients the best chance of immediate and ultimate functional recovery. However, as these injuries are rare, there is paucity in prospective comparative studies large enough to provide high level evidence for best practice. This lack of comprehensive and convincing evidence has made the management of multiligamentous knee injuries an area of active debate and controversy. The debate on whether surgical management leads to better outcomes than non-operative management, the optimal timing of surgery after injury and whether repair is better than reconstruction is still ongoing. Using the Oxford Levels of Evidence, this review summarises the latest high level evidence to provide answers to these issues. Recommendations for practice have also been offered and assigned a grade using a published scale.

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Results after Treatment of Traumatic Knee Dislocations: A Report of 26 Cases

Abstract: Operative treatment makes possible the recovery of structures that provide enough stability to perform day-to-day activities in the majority of cases.

Cited by 115 publications

References 17 publications

Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

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

State of the Art Regarding the Management of Multiligamentous Injuries of the Knee

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