Long-Term Functional Results and Complications in Patients with Knee Dislocations

Abstract

This retrospective study evaluated outcome and associated complications in 48 patients with 50 knee dislocations treated between 1968 and 1993. Average follow-up was 8.3 years. Thirty-one knees underwent operative treatment, and 19 knees underwent nonoperative treatment. Open dislocations occurred in 26% of knees, and associated injuries occurred in 58%. Peroneal nerve injuries occurred most frequently (36%), followed by popliteal artery injuries (24%). Six knees treated nonoperatively required either aboveknee amputation (4) or knee arthrodesis (2). Mean Lysholm at follow-up was 80.2 and Hospital for Special Surgery (HSS) score was 76.8. Differences in HSS score (P = .001), Lysholm score (P = .007), pain with rest, knee flexion, and return to athletics were statistically significant between patients treated operatively and nonoperatively, with operative patients scoring better. Patients treated surgically were less likely to develop severe radiographic degenerative changes. These findings demonstrate patients treated operatively for knee dislocations have better functional results.[J Knee Surg. 2008;21:261-268.]

Long-term Followup of Surgically Treated Knee Dislocations: Stability Restored, but Arthritis Is Common

“…Furthermore, most studies are small retrospective cohorts that contain considerable variability in terms of surgical treatment, injury patterns, and mechanism of injury [26]. A review of the literature for long-term outcomes returned only five peer-reviewed articles documenting average outcomes greater than 5 years postoperatively [1, 5,12,27,28]. With few studies focused on long-term followup, it was the purpose of this study to characterize the long-term recovery of the surgically treated patient with knee dislocation by focusing on four key issues: knee stability, return to preinjury level of function, development of radiographic signs of arthrosis, and ROM loss.…”

“…Use of the Lysholm and Tegner scales has been applied previously to the long-term assessment of the patient with knee dislocation [1, 5,12,27,28].…”

“…Furthermore, there is a paucity of data related to clinical and functional outcomes for the surgical treatment of knee dislocation injuries [19]. Few studies have shown successful results with up to 10 years of followup [1,5,9,12,27,28]. Even fewer studies include a substantial numbers of patients whose followup is into the second decade and beyond [12].…”

Trauma of the External Popliteal Sciatic Nerve (SPE) Following a Dislocation of the Knee: About a Case

“…Others emphasize the spontaneous and rapid recovery of paralysis (6,9,10) . Despite a significant rate of rupture or non-recovery, several authors do not report the impact of neurological sequelae on the final result (11,12,13) . In urgent cases, the risk of an irreversible lesion of the SPE nerve is not clearly known.…”

Ipsilateral hip and knee dislocation: Case report and review of literature

“…The incidence of concomitant neurologic injury with knee dislocation is reported to be from 10% to 40%. 15,16 The indications for peroneal neurolysis and cable grafting in the setting of knee dislocations are controversial. Patients who are undergoing PLC repair or reconstruction and have a peroneal nerve injury should be treated with at least a peroneal neurolysis.…”