Return to Sport After Multiligament Knee Injury in Young Athletes

Fine, River; Curtis, William E.; Stevens, Kristin L.; Imada, Allicia O; Stein, Elena R.; Treme, Gehron; Schenck, Robert C.; Richter, Dustin L.

doi:10.1177/23259671231179109

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…The International Knee Documentation Committee (IKDC) is a 100-point scoring system in which a higher score means better functional outcomes and less disability. It has three main elements: symptoms, sports activities, and knee function [ 20 ]. The Tegner score assesses the ability to practice sports activities and work.…”

Section: Methodsmentioning

confidence: 99%

Irreducible knee dislocation: improved clinical outcomes of open and arthroscopic surgical treatment. A systematic review of the literature

Giustra,

Bosco,

Masoni

et al. 2023

Eur J Orthop Surg Traumatol

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Purpose Irreducible knee dislocations (IKDs) are a rare rotatory category of knee dislocations (KDs) characterized by medial soft tissue entrapment that requires early surgical treatment. This systematic review underlines the need for prompt surgical reduction of IKDs, either open or arthroscopically. It describes the various surgical options for ligament management following knee reduction, and it investigates their respective functional outcome scores to assist orthopedic surgeons in adequately managing this rare but harmful KD. Methods A comprehensive search in four databases, PubMed, Scopus, Embase, and MEDLINE, was performed, and following the PRISMA guidelines, a systematic review was conducted. Strict inclusion and exclusion criteria were applied. Studies with LoE 5 were excluded, and the risk of bias was analyzed according to the ROBINS-I tool system. This systematic review was registered on PROSPERO. Descriptive statistical analysis was performed for all data extracted. Results Four studies were included in the qualitative analysis for a total of 49 patients enrolled. The dimple sign was present in most cases. The surgical reduction, either open or arthroscopically performed, appeared to be the only way to disengage the entrapped medial structures. After the reduction, torn ligaments were addressed in a single acute or a double-staged procedure with improved functional outcome scores and ROM. Conclusions This systematic review underlines the importance of promptly reducing IKDs through a surgical procedure, either open or arthroscopically. Moreover, torn ligaments should be handled with either a single acute or a double-staged procedure, leading to improved outcomes. Level of evidence IV.

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Section: Methodsmentioning

confidence: 99%

Irreducible knee dislocation: improved clinical outcomes of open and arthroscopic surgical treatment. A systematic review of the literature

Giustra,

Bosco,

Masoni

et al. 2023

Eur J Orthop Surg Traumatol

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Effect of Timing of Surgery on the Outcomes and Complications in Multi-ligament Knee Injuries: An Overview of Systematic Reviews and A Meta-analysis

Vaishya,

Patralekh,

Vaish

et al. 2024

JOIO

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Return to Sport After Multiligament Knee Injury: A Systematic Review of the Literature

D’Ambrosi,

Meena,

Ursino

et al. 2024

JOIO

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Purpose The objective of this study was to conduct a comprehensive assessment of MLKI outcome studies in order to ascertain the overall rates of return to sport following MLKI. Methods A systematic review was conducted based on the PRISMA guidelines. Quality assessment of the systematic review was performed using the MINORS Score. The following search terms were browsed in the title, abstract, and keyword fields: “multiligament knee” or “MLKI" AND “return to sport” or “sports activity” or "athletes" or "sports" or "sportsman". The resulting measures extracted from the studies were the rate of RTS, level of RTS, complications, revision surgery, Tegner, International Knee Documentation Committee (IKDC) Lysholm and anterior cruciate ligament-return to sport after injury (ACL-RSI). Results A total of 439 patients were included in the study, of whom 383 (87.2%) were male and 56 (22.8%) were female. The mean age at surgery was 28.06 ± 8.93 years. The mean time from injury to surgery was 97.68 ± 127.81 weeks, while the mean follow-up was 42.83 ± 39.22 months. Of 312 patients who completed the follow-up and reported to be sportsmen before surgery, 184 (58.97%) returned to the same or higher pre-injury level, 58 (18.58%) returned to a lower level, while 69 (22.11%) did not return to sports activity. The author analysed the Tegner score in three studies and noted a decrease compared to the pre-injury level (from 7.12 ± 0.8 pre-injury to 4.59 ± 0.57 at the final follow-up; p < 0.001). At the final follow-up, 4 studies analysed IKDC with a mean value of 75.14 ± 9.6, 3 reported a mean Lysholm of 51.81 ± 27.6, and two reported a mean ACL-RSI of 64.82 ± 0.149. Among the 439 patients, a total of 90 (20.5%) complications/re-operations were reported, while a total of 29 (6.6%) failures were recorded. Conclusions Return to sport after MLKI occurs in approximately 75% of surgically treated patients, though return to high-level sport is about 60% of the patients. Furthermore, one in five patients report complications, while the failure rate is relatively low (< 7%). Level of Evidence Systematic review of level 4.

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Return to Sport After Multiligament Knee Injury in Young Athletes

Abstract: This article is temporarily under embargo.

Cited by 4 publications

References 23 publications

Irreducible knee dislocation: improved clinical outcomes of open and arthroscopic surgical treatment. A systematic review of the literature

Irreducible knee dislocation: improved clinical outcomes of open and arthroscopic surgical treatment. A systematic review of the literature

Effect of Timing of Surgery on the Outcomes and Complications in Multi-ligament Knee Injuries: An Overview of Systematic Reviews and A Meta-analysis

Return to Sport After Multiligament Knee Injury: A Systematic Review of the Literature

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