Mid-Term Results following Traumatic Knee Joint Dislocation
Purpose: Although treatment strategies of knee joint dislocations have evolved, there is still no consensus on the best method and timing. New therapeutic concepts suggest that early one-stage treatment, including suturing and bracing of the cruciate ligaments in acute knee joint dislocation, are le...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/1/266 |
| _version_ | 1797625493434925056 |
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| author | Julius Watrinet Christian von Rüden Stephan Regenbogen Andreas Brand Markus Bormann Fabian M. Stuby Julian Fürmetz |
| author_facet | Julius Watrinet Christian von Rüden Stephan Regenbogen Andreas Brand Markus Bormann Fabian M. Stuby Julian Fürmetz |
| author_sort | Julius Watrinet |
| collection | DOAJ |
| description | Purpose: Although treatment strategies of knee joint dislocations have evolved, there is still no consensus on the best method and timing. New therapeutic concepts suggest that early one-stage treatment, including suturing and bracing of the cruciate ligaments in acute knee joint dislocation, are leading to improved functional results. This study aimed to evaluate the midterm functional outcome following traumatic knee joint dislocation and to determine whether the outcome is influenced by the surgical management, patient habitus or concomitant injuries. Methods: In this retrospective single center study, 38 patients with acute Schenck type II to IV knee dislocations were treated over an eight-year period in a level I trauma center. At follow-up, various clinical scores, such as the International Knee Documentation Committee (IKDC) Score, Lysholm Score, and Tegner Activity Scale (TAS), and individual questions about rehabilitation and activity levels of 38 patients were evaluated. Results: Mean follow-up was 5.5 ± 2.7 years. The mean IKDC Score was 65.6 ± 15.7 points, the average Lysholm Score was 70.5 ± 16.4 points and the median TAS was 4 (0–7), resulting in a loss of activity of 2 (range 0–6) points. There was no significant difference between a one-stage treatment compared to a two-stage approach. Ligament reconstruction of the ACL in a two-stage approach was required in only 33.3%. Further operations (early and late) were performed in 37% of cases. Being overweight was associated with more complications and worse outcomes, and external fixation with arthrofibrosis. Conclusions: Knee dislocation is a severe trauma that often leads to a prolonged loss of function and increased knee pain over years, affecting the patient’s activity. Clinical outcome is influenced significantly by concomitant injuries. Severe cases with initial external fixation are associated with a higher risk of knee stiffness and should be considered during rehabilitation. Obese patients present a challenge due to higher complication rates and lower postoperative knee function. Level of evidence: Retrospective single center study, level III. |
| first_indexed | 2024-03-11T09:57:13Z |
| format | Article |
| id | doaj.art-b4189d8bc17f4286affab2fa92223d41 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:57:13Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b4189d8bc17f4286affab2fa92223d412023-11-16T15:43:45ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112126610.3390/jcm12010266Mid-Term Results following Traumatic Knee Joint DislocationJulius Watrinet0Christian von Rüden1Stephan Regenbogen2Andreas Brand3Markus Bormann4Fabian M. Stuby5Julian Fürmetz6Department Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyDepartment Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyDepartment Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyInstitute for Biomechanics, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 81377 Munich, GermanyDepartment Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyDepartment Trauma Surgery, BG Unfallklinik Murnau, 82418 Murnau, GermanyPurpose: Although treatment strategies of knee joint dislocations have evolved, there is still no consensus on the best method and timing. New therapeutic concepts suggest that early one-stage treatment, including suturing and bracing of the cruciate ligaments in acute knee joint dislocation, are leading to improved functional results. This study aimed to evaluate the midterm functional outcome following traumatic knee joint dislocation and to determine whether the outcome is influenced by the surgical management, patient habitus or concomitant injuries. Methods: In this retrospective single center study, 38 patients with acute Schenck type II to IV knee dislocations were treated over an eight-year period in a level I trauma center. At follow-up, various clinical scores, such as the International Knee Documentation Committee (IKDC) Score, Lysholm Score, and Tegner Activity Scale (TAS), and individual questions about rehabilitation and activity levels of 38 patients were evaluated. Results: Mean follow-up was 5.5 ± 2.7 years. The mean IKDC Score was 65.6 ± 15.7 points, the average Lysholm Score was 70.5 ± 16.4 points and the median TAS was 4 (0–7), resulting in a loss of activity of 2 (range 0–6) points. There was no significant difference between a one-stage treatment compared to a two-stage approach. Ligament reconstruction of the ACL in a two-stage approach was required in only 33.3%. Further operations (early and late) were performed in 37% of cases. Being overweight was associated with more complications and worse outcomes, and external fixation with arthrofibrosis. Conclusions: Knee dislocation is a severe trauma that often leads to a prolonged loss of function and increased knee pain over years, affecting the patient’s activity. Clinical outcome is influenced significantly by concomitant injuries. Severe cases with initial external fixation are associated with a higher risk of knee stiffness and should be considered during rehabilitation. Obese patients present a challenge due to higher complication rates and lower postoperative knee function. Level of evidence: Retrospective single center study, level III.https://www.mdpi.com/2077-0383/12/1/266kneeknee dislocationACLPCLexternal fixationarthrofibrosis |
| spellingShingle | Julius Watrinet Christian von Rüden Stephan Regenbogen Andreas Brand Markus Bormann Fabian M. Stuby Julian Fürmetz Mid-Term Results following Traumatic Knee Joint Dislocation Journal of Clinical Medicine knee knee dislocation ACL PCL external fixation arthrofibrosis |
| title | Mid-Term Results following Traumatic Knee Joint Dislocation |
| title_full | Mid-Term Results following Traumatic Knee Joint Dislocation |
| title_fullStr | Mid-Term Results following Traumatic Knee Joint Dislocation |
| title_full_unstemmed | Mid-Term Results following Traumatic Knee Joint Dislocation |
| title_short | Mid-Term Results following Traumatic Knee Joint Dislocation |
| title_sort | mid term results following traumatic knee joint dislocation |
| topic | knee knee dislocation ACL PCL external fixation arthrofibrosis |
| url | https://www.mdpi.com/2077-0383/12/1/266 |
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