Total Knee Arthroplasty to Treat Acute Knee Dislocation Associated With Osteoarthritis: a Case Report

Xiong, Huazhang; Li, Yuwan; Yu, Hao; Jin, Ying; Wei, Xicheng; Peng, Jiachen; Liu, Yi

doi:10.21203/rs.3.rs-910434/v1

Cited by 1 publication

(1 citation statement)

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“…In a systematic review, Medina et al reported up to 18% of vascular injuries and up to 25% of nerve injuries [19]. Treatment guidelines for knee dislocation typically include reduction of the knee joint, stabilisation with external or internal fixation, reconstruction of injured neurovascular and ligamentous structures and rehabilitation procedures to restore joint function [12, 15, 24, 28, 37].…”

Section: Introductionmentioning

confidence: 99%

No effect of dislocation status at arrival in emergency department on outcome of knee joint dislocations

Szymski,

Huber,

Riedl

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeKnee dislocation is a rare but severe injury of the lower extremities. The aim of this study was to report on the epidemiology, diagnostics and treatment of such injuries and to identify negative predictors of clinical outcomes.MethodsThis retrospective analysis included all knee dislocations treated at a Level I Trauma Centre in Germany between 2009 and 2021. Medical records were categorised, collected and analysed in a standardised manner. A follow‐up visit 1 year after the injury focused on limitations in knee mobility.ResultsA total of 120 knee dislocations were included in the study. 29.3% of patients presented to the emergency department with a dislocated joint, and 17.5% (n = 21) had a neurovascular lesion. At follow‐up 12 months after the injury, 65.8% of the patients reported limitations in the range of motion, and 11.7% (n = 14) reported severe limitations in daily activities. Site infections due to surgery occurred in 3.3% of patients. Increased body weight (r = 0.294; p < 0.001 and r = 0.259; p = 0.004), an increased body mass index above 25 kg/m2 (body mass index, r = 0.296; p < 0.001 and r = 0.264; p = 0.004) and deficits in peripheral perfusion as well as sensory and motor function (r = 0.231; p = 0.040 and r = −0.192; p = 0.036) were found to be negative predictive factors for clinical outcome. For posttraumatic neurovascular injury, lack of peripheral perfusion, insufficient sensory and motor function (r = −0.683; p < 0.0001), as well as a higher Schenck grade (r = 0.320; p = 0.037), were identified as independent risk factors. The status of dislocation at the site of the accident and on arrival at the emergency department had no impact on the outcome or neurovascular injury.ConclusionKnee dislocation is a rare injury with a high rate of severe complications such as neurovascular lesions. In particular, the initial status of neurovascular structures and injury classification showed a relevant negative correlation with the posttraumatic status of nerves and vessels. In particular, patients with these characteristics need close monitoring to prevent negative long‐term consequences.Level of EvidenceLevel III.

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Section: Introductionmentioning

confidence: 99%