Surgical Management of Traumatic Knee Dislocation

Ibrahim, Samir Abdul Razik; Ahmad, Fawzy Hamido F.; Salah, Mahmoud; Misfer, Abdul Rahman K. Al; Ghaffer, Samy Abdul; Khirat, Shrief

doi:10.1016/j.arthro.2007.08.007

Cited by 97 publications

(84 citation statements)

References 25 publications

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“…However, the authors in that report did not categorize nerve palsies into complete versus incomplete injuries, which limits the ability to assess injury severity and subsequent nerve-related outcomes. Several recent studies have reported on the subjective and objective outcome scores of patients who sustain multiligamentous knee injury [11,12,17], but there remains a paucity of literature regarding how concomitant peroneal nerve palsy, and its potential recovery, affects outcome [20]. To our knowledge, no previous studies have compared a matched cohort of patients with and without peroneal nerve palsy in the setting of multiligament knee injury.…”

Section: Introductionmentioning

confidence: 89%

“…Treatment for complete nerve palsy included an ankle-foot orthosis for all patients, nonoperative (one), neurolysis (two), tendon transfer (three), nerve transfer (one), and combined nerve/tendon transfer (one). Treatment for partial nerve palsy included nonoperative (12), neurolysis (four), nerve transfer (one), and combined nerve/tendon transfer (one). Furthermore, patients without nerve injury were matched by Schenck classification, age, and sex.…”

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confidence: 99%

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Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

Krych

Giuseffi

Kuzma

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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BackgroundPeroneal nerve palsy is a frequent and potentially disabling complication of multiligament knee dislocation, but little information exists on the degree to which patients recover motor or sensory function after this injury, and whether having this nerve injury-with or without complete recovery-is a predictor of inferior patient-reported outcome scores. Questions/purposes The purposes of this study were to (1) report on motor and sensory recovery as well as patientreported outcomes scores of patients with peroneal nerve injury from multiligament knee dislocation; (2) compare those endpoints between patients who had partial versus complete nerve injuries; and (3) compare patient-reported outcomes among patients who sustained peroneal nerve injuries after knee dislocation with a matched cohort of multiligament knee injuries without nerve injury. Methods Thirty-two patients were identified, but five did not have 2-year followup and are excluded (16% lost to followup). Twenty-seven patients (24 male, three female) with peroneal nerve injury underwent multiligament knee reconstruction and were followed for 6.3 years (range, 2-18 years). Motor grades were assessed by examination and outcomes by International Knee Documentation Committee (IKDC) and Lysholm scores. Retrospectively, patients were divided into complete (n = 9) and partial nerve palsy (n = 18). Treatment for complete nerve palsy included an ankle-foot orthosis for all patients, nonoperative (one), neurolysis (two), tendon transfer (three), nerve transfer (one), and combined nerve/tendon transfer (one). Treatment for partial nerve palsy included nonoperative (12), neurolysis (four), nerve transfer (one), and combined nerve/tendon transfer (one). Furthermore, patients without nerve injury were matched by Schenck classification, age, and sex. Data were analyzed using univariate and multivariate models. Results Overall, 18 patients (69%) regained antigravity ankle dorsiflexion after treatment (three complete nerve palsy [38%] versus 15 partial nerve palsy [83%]; p = 0.06). One patient with complete nerve palsy (13%) and 13 patients with partial nerve palsy (72%) regained antigravity extensor hallucis longus strength (p = 0.01). IKDC and Lysholm scores were similar between complete nerve palsy and partial nerve palsy groups. After controlling for confounding variables such as patient age, body mass index, injury interval to surgery, mechanism of injury, bicruciate injury, and popliteal artery injury status, there was no difference between patients with peroneal nerve injury and those without on Lysholm or IKDC scores.

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Section: Introductionmentioning

confidence: 89%

mentioning

confidence: 99%

Is Peroneal Nerve Injury Associated With Worse Function After Knee Dislocation?

Krych

Giuseffi

Kuzma

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Several authors have reported [9,13,41] a loss of flexion of less than 12°, improved stability, and high subjective scores with single-stage surgery of all involved stabilizing structures. However, these studies included predominantly low-energy or lower-grade (\ KD-IV) knee dislocations and excluded open dislocations and patients with vascular lesions and associated fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Many authors advocate the use of aggressive rehabilitation to avoid postoperative stiffness despite the risk of placing excessive force on the graft tissue [5,12,13,24,36]. In recent papers, high subjective scores, reasonable stability, and a return to activities were achieved by performing simultaneous reconstruction of the ACL and PCL, as well as medial or lateral structures, followed by an aggressive rehabilitation protocol [5,12,13].…”

Section: Introductionmentioning

confidence: 99%