Outcome after knee dislocations: a 2–9 years follow-up of 85 consecutive patients

Abstract

Dislocation of the knee is a relatively rare injury with modern arthroscopic techniques, operative reconstruction has become the standard of care. The primary aim of this study was to prospectively follow a large, consecutive series of patients with knee dislocation to document associated injuries, surgical treatment, knee function, and knee osteoarthritis (OA) at a minimum of 2 years follow-up. Hundred and twenty-two consecutive patients with a traumatic knee dislocation (Schenck II-IV) were treated at the Oslo University Hospital, Ulleval, between May 1996 and December 2004. Follow-up evaluation of 85 patients consisted of evaluation of knee joint laxity using the KT1000, the Lachman test, the pivot shift test, the reversed pivot shift, the posterior drawer test, the dial test, and the varus-valgus tests compared to the uninjured knee. Knee function was evaluated using the Lysholm score, the Tegner activity level score, the IKDC2000 score, and four single leg hop tests. Radiographic evaluation was performed using the Kellgren & Lawrence classification grade 0-4. Knee function at a minimum of 2 years after surgery disclosed a Lysholm score of a median of 83, a Tegner activity score of 5, and above 83% on all single leg hop tests compared to the uninjured side. Knee function was lower in the patients with a knee dislocation caused by high-energy trauma compared to low energy trauma. Eighty-seven percent had Kellgren & Lawrence grade 2 or higher for the injured knee compared to 35% for the uninjured knee.

Posterior Tibial Tendon Transfer Improves Function for Foot Drop After Knee Dislocation

“…This result is comparable to other studies showing a common peroneal nerve palsy incidence of 14% to 40% [3,14,16,21,28]. The differences among the studies might be the result of different patient populations.…”

“…Our inclusion criteria excluded patients with severe intraarticular fractures (Schenck Classification V) and less severe knee trauma (Schenck Classification I). Some studies also included patients with pure sensory dysfunction of the nerve [3,16], whereas we focused on patients with severe motor dysfunction due to injury to the common peroneal nerve. We consider a sensory dysfunction as less disabling and chose to exclude these patients.…”

“…All 247 patients were entered into a prospective database and have been followed since the time of injury. In an early report from this database covering 85 patients [3], 51% were highenergy trauma, but unfortunately we do not have more detailed data on the larger cohort of all 247 at the time of this publication. This study was approved by the regional ethics committee (05.06.2012; reference: 2012/873), and informed consent was obtained before patient inclusion.…”

“…1). The inclusion criterion was a knee dislocation defined as an injury to both the ACL and PCL with an additional injury to the lateral and/or medial ligaments (Schenck Classification II to IV) [3]. Patients with severe intraarticular fracture of the knee (Schenck Classification V) or skeletal immaturity were not included.…”

“…Knee dislocation is often associated with additional injuries to the affected leg, such as injury to the popliteal artery (23%-32%) [6,26], compartment syndrome, injury to the tibial nerve [13,25,30], and more often injury to the common peroneal nerve (14%-40%) [3,14,16,21,28].…”