Non-reducible knee dislocation with interposition of the vastus medialis muscle

Bistolfi, Alessandro; Massazza, Giuseppe; Rosso, Federica; Ventura, Stefano; Cenna, E.; Drocco, Luca; Crova, Maurizio

doi:10.1007/s10195-011-0134-2

Cited by 13 publications

(16 citation statements)

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“…There is still no consensus as to the best surgical method, and treatment options range from arthroscopic debridement of the capsule-ligament structures (28) to open reduction and removal of the muscle interposition (14,(29)(30)(31). In cases of muscle dislocation different surgical choices are advocated: sectioning of the muscle to allow reduction of the knee dislocation (27) or repair of the muscle rupture to return the muscle to its anatomical site (29). Durakbaşa et al reported that the medial meniscus may often be detached from the meniscocapsular junction and in these cases it is necessary to extract the medial meniscus from the joint to reduce the dislocation (32).…”

Section: J Ointsmentioning

confidence: 99%

“…In the literature, there is no universal agreement as to whether and when lesions of the cruciate ligaments should be repaired. A one-step reduction method combining arthroscopic cruciate ligament reconstruction is described (29,33). In this kind of lesion, Bistolfi et al (29) confirmed that lateral and rotational stability must be achieved immediately by reconstruction or suture of the peripheral structures, while reconstruction of the cruciate ligaments can be postponed and even avoided in elderly patients or those not professionally engaged in high level sports.…”

Section: J Ointsmentioning

confidence: 99%

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Irreducible posterolateral dislocation of the knee: a case report

Solarino¹,

Notarnicola²,

Maccagnano³

et al. 2015

Joints

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Irreducible posterolateral dislocations of the knee are rare lesions, generally caused by high-energy trauma inducing rotational stress and a posterior and lateral displacement of the tibia. In these conditions, the interposition of abundant soft tissue inside the enlarged medial joint space prevents spontaneous reduction or non-surgical treatment by manipulation of the dislocation. Surgical treatment is therefore compulsory. We report the clinical case of a woman who suffered a subluxation of the knee while jogging. The case we describe is of interest because it shows that even less severe knee dislocations, like this subluxation caused by a low-velocity sports trauma, may present in an irreducible form requiring open surgery. Clinicalinstrumental monitoring did not reveal any signs of vascular or nerve injury. Owing to the irreducibility of the lesion we were obliged to perform open surgery in order to free the joint from the interposed muscle tissue and repair medial capsule-ligament lesions. Repair of the damaged cruciate ligaments was deferred to a second stage, but ultimately rendered necessary by the persistence of joint instability and the need to address the patient's functional needs. In the literature, different one-and two-step surgical options, performed by arthroscopy or arthrotomy, are reported for such related problems. The Authors discuss these various options and examine and discuss their own decision taken during the surgical work-up of this case.Key Words: knee, posterolateral, dislocation, anterior cruciate ligament, injury. IntroductionDislocation of the knee is a rare orthopaedic emergency that requires appropriate monitoring and treatment. It has a low estimated annual incidence, accounting for less than 0.01% of trauma episodes, even if the true number of cases is unknown because many dislocations reduce spontaneously already at the site of the traumatic event (1). Most lesions of this kind are caused by high-velocity sports traumas (2), in which traumatic forces produce stress in the sagittal plane of the knee in the anteroposterior direction and in the frontal plane in varus-valgus angulation (3), inducing a rotational dislocation of the tibia in relation to the femoral condyles. This causes lesions of the ligament structures, also involving the popliteal artery in 20% of cases and the common peroneal or tibial nerve in 19% (4). In the literature, the role of non-surgical "closed" reduction is emphasized (5), while surgical treatment should be reserved for irreducible cases or those in which vesselnerve complications arise or there are signs of immediate joint instability (6). Case reportA healthy 51-year-old woman suffered a traumatic sprain of her left knee when she fell while jogging. Unable to stand or walk, she was immediately transfer-

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Section: J Ointsmentioning

confidence: 99%

Section: J Ointsmentioning

confidence: 99%

Irreducible posterolateral dislocation of the knee: a case report

Solarino¹,

Notarnicola²,

Maccagnano³

et al. 2015

Joints

View full text Add to dashboard Cite

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“…[1][2][3] This injury typically occurs when a valgus force is applied to a flexed knee with external rotation of the tibia. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The medial femoral condyle button-holes through the torn medial capsuloligament complex as a flexed knee is forced into severe valgus. As the deforming force dissipates, the knee partially reduces.…”

mentioning

confidence: 99%

“…Over the past two decades, open reduction has been the most widely used method for the management of irreducible posterolateral knee dislocation. [4][5][6][7][8][9][10][11][12][13][14] Although this method is simple and reportedly yields satisfactory clinical outcomes, it can cause further damage to the torn medial structures and could result in fluid extravasation into the soft tissues around the joint during cruciate ligament reconstruction.…”

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confidence: 99%

“…31 No. 10/2018divided into three categories:(1) open reduction combined with ligament reconstruction or repair, (2) arthroscopic reduction combined with ligament reconstruction or repair, and(3)total knee replacement, which is more suitable for elderly patients with advanced joint osteoarthritis [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Kilicogluet al reported a patient who underwent a onestage procedure of open reduction combined with ACL/PCL reconstruction and simultaneous MCL repair for irreducible posterolateral knee dislocation.…”

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One-Stage Arthroscopic Reduction Combined with Multiligament Reconstruction or Repair for Irreducible Posterolateral Knee Dislocation: A Retrospective Case Series with Minimum 2-Year Follow-Up

Zhuo

2018

J Knee Surg

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The purpose of this study was to evaluate the clinical outcomes after arthroscopic management of irreducible posterolateral knee dislocation. Twenty-one patients with irreducible posterolateral knee dislocation were treated in our institution from January 2009 to May 2014. Inclusion criteria were as follows: (1) patients who underwent one-stage arthroscopic reduction combined with multiligament reconstruction or repair and (2) patients with a minimum 2-year follow-up. Knee stability was assessed using physical examination and side-to-side differences (SSD) determined with a KT-1000 arthrometer and Telos stress device. Other assessments included the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, and patient satisfaction rate. Thirteen of the 21 patients (8 males and 5 females) met our inclusion criteria and were included in this analysis. The mean age was 37.8 years (range, 27-56 years). The mean time from injury to surgery was 1.84 days (range, 1-3 days). The mean follow-up period was 32.6 months (range, 24-46 months). At the final follow-up, with the exception of one patient who had an abnormal valgus stress test, all patients achieved normal or nearly normal Lachman test, pivot shift test, posterior drawer test, and varus and valgus stress tests. The mean SSD of total anterior-posterior translation and isolated anterior translation determined with a KT-1000 arthrometer were 2.15 ± 1.57 mm (range, 0-6 mm) and 1.61 ± 0.86 mm (range, 1-4 mm), respectively. The mean SSD of anterior translation, posterior translation, and medial and lateral joint gapping determined with a Telos stress device were 2.23 ± 0.92 mm (range, 1-4 mm), 3.23 ± 1.16 mm (range, 2-5 mm), 1.77 ± 1.87 mm (range, 0-7 mm), and 0.46 ± 0.52 mm (range, 0-2 mm), respectively. The IKDC subjective score, Lysholm score, and Tegner score improved significantly postoperatively ( = 0.001) with a satisfaction rate of 84.6%. One-stage arthroscopic reduction combined with multiligament reconstruction or repair was an effective, reliable treatment for irreducible posterolateral knee dislocation. This is a case series with level of evidence as IV.

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Osimani¹,

Chillemi²

2016

A-Z Notes in Radiological Practice and Reporting

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Non-reducible knee dislocation with interposition of the vastus medialis muscle

Cited by 13 publications

References 13 publications

Irreducible posterolateral dislocation of the knee: a case report

Irreducible posterolateral dislocation of the knee: a case report

One-Stage Arthroscopic Reduction Combined with Multiligament Reconstruction or Repair for Irreducible Posterolateral Knee Dislocation: A Retrospective Case Series with Minimum 2-Year Follow-Up

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