Treatment of acute knee dislocations

Pfeiffer, Thomas R.; Günther, Daniel

doi:10.1007/s00113-023-01369-y

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…While conservative treatment showed inferior results, primary stabilisation of highly unstable knee joints with an external fixator or primary ligament bracing showed significantly better results [9,12,15,24]. A meta-analysis published by Frosch et al comparing ligament bracing and reconstruction of the ACL and/or PCL showed comparable results, including dislocation of Schenck II and higher dislocations [4].…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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: Discussionmentioning

confidence: 99%

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.

View full text Add to dashboard Cite

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Knee joint dislocations—Current epidemiology and treatment in Germany

Weber,

Szymski,

Huber

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeKnee joint dislocations, though rare, present significant challenges due to potential complications like vascular and nerve damage, and are known to be often linked to sports injuries, accidents and obesity. This study aims to analyse the epidemiology, incidence and treatment approaches for knee dislocations in Germany from 2019 to 2022.MethodsThis retrospective cohort study utilized data from the German Institute for the Hospital Remuneration System to examine knee dislocation cases across German medical institutions. Patient data coded under International Statistical Classification of Diseases and Related Health Problems 10 for ‘knee dislocation’ enabled detailed analysis by age, sex and surgical procedures categorized by operation and procedure codes. The Patient Clinical Complexity Level (PCCL) assessed complication severity.ResultsAnalysis of 1643 knee dislocation cases revealed an incidence rate of 0.44–0.54 per 100,000 inhabitants annually. During the years 2020 and 2021, there were fewer cases of knee dislocations. Male patients comprised 50%–56% of cases, with an average hospital stay of 11 days. Most cases were PCCL 0 (62%–72%) and predominantly affected patients aged 18–29 years. Anterior tibial dislocations were common among classified cases. Injuries included ligament ruptures, meniscus lesions and grade I soft‐tissue injuries. Patients with pre‐existing knee prostheses constituted 0%–16% annually. Treatment involved closed reduction, external fixation and surgeries like capsuloligamentous reconstructions and arthroscopic procedures. Revision knee arthroplasty was required in 2%–9% of cases, with obesity rates up to 7%.ConclusionsThis study provides valuable insights into the epidemiology, incidence and treatment of knee dislocations in Germany, with a focus on demographic risk factors, treatment complexities and the impact of obesity and knee prostheses. The findings emphasize the importance of specialized care in larger hospitals, comprehensive management of concomitant injuries and the need for improved coding accuracy. Future research should aim to refine treatment protocols.Level of EvidenceLevel III.

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Treatment of acute knee dislocations

Cited by 2 publications

References 32 publications

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

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

Knee joint dislocations—Current epidemiology and treatment in Germany

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