Surgical Management of Knee Dislocations

Chhabra, Anikar; Peter, S.; Rihn, Jeffrey A.; Cole, Brian J.; Bennett, Craig; Waltrip, Robert L.; Harner, Christopher D.

doi:10.2106/jbjs.d.02711

Cited by 119 publications

(37 citation statements)

References 2 publications

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“…Ultimately 8-22% of patients with knee dislocations have a vascular injury requiring repair [1,9,10,12,14]. A slightly higher percentage has been reported with open knee dislocations (26%) [18] which was similar to our study (29%).…”

Section: Discussionsupporting

confidence: 86%

Surgical outcomes after traumatic open knee dislocation

King

Cerynik

Blair

et al. 2009

Knee Surg Sports Traumatol Arthrosc

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The purpose of this study is to describe the types of injuries and surgical treatments associated with open knee dislocations and to present the functional outcomes of these patients. Between 2001 and 2005, the medical records of patients that sustained traumatic open knee dislocations at our Level 1 Trauma Center were retrospectively reviewed. Initial surgical intervention was performed in all patients including placement of spanning external fixator, repair of vascular injuries if necessary, and irrigation and debridement of the open wounds. Ligamentous reconstruction was delayed until after limb salvage. The Short Form-12 was the primary outcome measure. Seven patients (five male, two female) had a mean age of 31.9 years (range 22-44) at the time of injury (five right, two left). Motorcycle accident was the most common cause (57%). Follow-up was a mean 27.6 months. The PCL was damaged in all patients. Three patients underwent angiography for absent/diminished pulses on initial exam with two requiring operative intervention. Three patients had associated common peroneal nerve injury (one iatrogenic). Ten (10.7) operative procedures were performed per patient (range 5-18) with an average of 6.6 debridements (range 2-11). Infection rate was 43% with one patient undergoing amputation for infection. Good to excellent results were found in 33% of patients. Most patients (86%) report some residual symptomatic or functional deficit. Due to the injury complexity in open traumatic knee dislocations, the surgical treatment is extensive and challenging. While infection rates are high, aggressive, individualized treatment can lead to satisfactory outcome although full return to activity is difficult to achieve using current treatment methods.

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Section: Discussionsupporting

confidence: 86%

Surgical outcomes after traumatic open knee dislocation

King

Cerynik

Blair

et al. 2009

Knee Surg Sports Traumatol Arthrosc

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show abstract

“…Disagreement persists regarding the timing of the procedure, which lateral side structures should be repaired or reconstructed, and how to treat associated cruciate ligament injuries. 2,7,9,12 Many authors advocate surgical repair or reconstruction of all torn lateral side structures in combination with anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstructions. 2,16,25,26,34,38,39 Despite the numerous studies describing various surgical techniques to treat dislocated knees with lateral side injuries, few studies have reported long-term outcomes or have had uniform results.…”

mentioning

confidence: 99%

Knee Dislocation with Lateral Side Injury

2007

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“…6,9,16 Other structural injuries, such as meniscal tears and chondral lesions, were treated simultaneously. For each sMCL reconstruction, a cryopreserved Achilles allograft was used.…”

Section: Surgical Techniquementioning

confidence: 99%