Epidemiology and outcomes of traumatic knee dislocations: Isolated vs multi-trauma injuries

Darcy, Genevieve; Edwards, Elton; Hau, Raphael

doi:10.1016/j.injury.2018.02.016

Cited by 40 publications

(53 citation statements)

References 15 publications

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“…Inclusion criteria were (1) radiographically documented KD; (2) PCL injury with associated injuries to the PMC, including the medial collateral ligament (MCL), and/or associated injuries to PLC, including the lateral collateral ligament (LCL); (3) bicruciate ligament injury and associated injury to at least one collateral ligament (KD-IIIM or KD-IIIL) [22]; and (4) injury to all four major ligaments (KD-IV). On the contrary, exclusion criteria were (1) chronic MLKIs or KDs, (2) no acute primary repair because of prolonged intensive care, (3) open knee dislocation, (4) knees with osteoarthritis, (5) patients with ACL injury and grade III MCL injury who underwent simultaneous ACL reconstruction and MCL repair, and (6) failure to complete the study questionnaire ( Fig. 1).…”

Section: Patientsmentioning

confidence: 99%

“…Therefore, it is difficult to apply a single approach and ideal surgical timing. Since MLKIs and KDs are uncommon and often heterogeneous, as mentioned above, minimal evidence is available, resulting in a lack of consensus regarding the most effective treatment [ 3 , 4 ]. Although conservative and surgical treatments have been reported, surgical interventions have generally been recommended because of poor outcomes after conservative treatment [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute primary repair of extraarticular ligaments and staged surgery in multiple ligament knee injuries

et al. 2020

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Background The purpose of this study is to compare the outcomes of acute primary repair of extraarticular ligaments with staged surgery for acute knee dislocations (KDs) and multiligament knee injuries (MLKIs). Materials and methods Between January 2005 and May 2018, 61 consecutive patients diagnosed with MLKI or KD were referred to or visited our institution. Of these, 31 patients who underwent acute repair of extraarticular ligaments within 3 weeks of injury were included in this study. These patients were retrospectively classified into two groups: those who underwent only primary repair (repair group) and those who underwent staged reconstructive surgery (staged group). Follow-up examination included range of motion (ROM), knee joint stability (Lachman test, posterior drawer test, and varus and valgus stress test), Lysholm knee score, Tegner activity scale, and Knee Injury and Osteoarthritis and Outcome Score (KOOS). Results Twelve of the 31 patients did not need or desire further surgery and were included in the repair group. No significant difference was observed in demographic data between the repair and staged groups. Although staged surgery decreased positive posterior drawer test results, no significant difference was observed between the two groups regarding ROM, other knee joint stability tests, Lysholm scores, Tegner scale, or KOOS. Conclusions In this series, all patients returned to their activities of daily living and preinjury occupation levels. Acute primary repair of extraarticular ligaments provides essential knee stability without varus/valgus instability and may reduce the need for subsequent cruciate ligament reconstruction. Level of evidence Level IV, retrospective observational study.

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Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute primary repair of extraarticular ligaments and staged surgery in multiple ligament knee injuries

et al. 2020

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“…Multiple ligament-injured knees (MLIKs) typically occur from either a traumatic knee dislocation or severe torsional trauma, and account for approximately 0.02-0.2% of all orthopedic injuries [1,2]. Limited evidence for optimal treatment is available, as these injuries have a low incidence and are often heterogeneous [3].…”

Section: Introductionmentioning

confidence: 99%

The multiple ligament-injured knee: When is primary repair an option?

et al. 2020

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“…Multiple ligamentous knee injuries are relatively rare, but may be associated with high energy trauma and need to be recognized due to potential devastating complications such as popliteal artery injury, peroneal nerve injury and/or compartment syndrome [4][5][6][7]. Previous studies have shown that patients with knee dislocations have a high rate of severe multi-system trauma [4,8,9].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of ligamentous knee injuries in pedestrian versus motor vehicle accidents

Steinmetz

McDonald

Tkach

et al. 2020

BMC Musculoskelet Disord

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Background: The purpose of this study was to determine the prevalence and characteristics of ligamentous knee injuries and to compare patient demographics, associated injuries and hospital stay to pedestrians who did not sustain a ligamentous knee injury. Methods: A retrospective review of all adult patients presenting as pedestrians struck by a motor vehicle to a level 1 trauma center over a three-year period was performed. Demographics, length of stay, orthopedic and nonorthopedic traumatic injuries were recorded. Magnetic resonance imaging was reviewed for ligamentous, bony and chondral injuries. Results: Five hundred thirty-nine patients were included. Sixty-seven (12.4%) patients sustained a total of 84 ligamentous knee injuries. OF these knee injuries that had MRI (55/84), the majority (96%) were multiligamentous in nature. Patients with ligamentous knee injury were more likely to also be affected by traumatic brain injury, solid organ injury, cervical and lumbar spine injury, pelvic ring injuries, distal femur fractures, patella fractures, knee dislocations, tibial plateau fractures, tibial pilon fractures, and deep vein thrombosis when compared to patients who did not sustain ligamentous knee injury. Patients who sustained ligamentous knee injury were more likely to require hospital and intensive care admission and had a longer overall hospital stay. Conclusion: Given the high prevalence of ligamentous knee injuries in this patient population, these patients should be thoroughly evaluated for a ligamentous knee injury. If ligamentous knee injury is suspected, MRI should be considered as a majority of these injuries involved multiple structures. Patients with ligamentous knee injuries often had multi-system injuries with resulting longer hospital stay when compared to those without ligamentous knee injuries.

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Epidemiology and outcomes of traumatic knee dislocations: Isolated vs multi-trauma injuries

Cited by 40 publications

References 15 publications

Acute primary repair of extraarticular ligaments and staged surgery in multiple ligament knee injuries

Acute primary repair of extraarticular ligaments and staged surgery in multiple ligament knee injuries

The multiple ligament-injured knee: When is primary repair an option?

Prevalence of ligamentous knee injuries in pedestrian versus motor vehicle accidents

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