Traumatic Dislocation of the Knee Joint

Section: Discussionsupporting

confidence: 85%

“…Knee dislocation is often associated with additional injuries to the affected leg, such as injury to the popliteal artery (23%-32%) [6,26], compartment syndrome, injury to the tibial nerve [13,25,30], and more often injury to the common peroneal nerve (14%-40%) [3,14,16,21,28].…”

Section: Introductionmentioning

confidence: 99%

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

Molund

Engebretsen

Hvaal

et al. 2014

“…The low incidence of this injury also presents barriers to epidemiologic investigation [3]. As a result, the current epidemiologic profile of multiligament knee injuries relies predominantly on merging data from various case series [3,5,6,16,20,23]. While this approach has yielded valuable information on patterns of patient presentation and injury mechanisms, it is handicapped by the intrinsic limitations of the constituent studies.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Multiligament Knee Reconstruction

Wilson

Mehta

Hương

et al. 2014

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

“…The PCL most often tears in a midsubstance-type pattern during lower energy sporting-type injuries and tears in avulsion-type injury patterns during high-energy trauma [20,29]. Schenck et al [28] found that midsubstance tears occur at a low strain rate and avulsion ''stripping'' injuries from the femoral side occur at a high strain rate in hyperextension in a cadaveric knee.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

Chen

Shi

Jiang

2012

Background Injury of the PCL of the knee in adults usually results in rupture rather than avulsion fracture and avulsions usually occur at the tibial insertion. Case Description We report an avulsion of the PCL with a femoral origin in a 22-year-old man who was injured by hyperflexion of the knee and was treated with arthroscopy. There were two parts in the partial osteochondral avulsion fracture of the PCL posteromedial (PM) bundle. One part was fixed with polydioxanone suture through drill holes and the other was removed. The fracture healed after 3 months and the knee was stable. At 11 months postoperatively the patient had returned to full-time work without pain or restrictions. The Lysholm II knee score was 95 points. Physical examination showed a negative posterior drawer sign. Literature Review We identified four other reported cases of PCL femoral origin avulsion fractures in adults. The subjects were 20 to 25 years old in four of five reports, including our patient. Three of the five patients had involvement of only the lateral cortex of the medial femoral condyle whereas two other patients including our patient, had an osteochondral fracture. The mechanism of PCL avulsion seems to be similar to that of a PCL rupture. Purposes and Clinical Relevance The hyperflexion injury may result in injury of the PM bundle of the PCL. Our case and one other in the literature suggest such avulsions need not involve the entire PCL.