Two-Stage Reconstruction With Autografts for Knee Dislocations

Ohkoshi, Yasumitsu; Nagasaki, Sumito; Shibata, Noboru; Yamamoto, Kazuki; Hashimoto, Tomoyuki; Yamane, Shigeru

doi:10.1097/00003086-200205000-00024

Cited by 85 publications

(52 citation statements)

References 11 publications

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“…Comparing our findings with those of other studies was difficult since the study populations often differed due to the heterogeneity of this type injury (Table 3). Ohkoshi et al [23] reported on a series of eight patients (KD-III) who underwent staged reconstruction: early PCL followed by delayed ACL reconstruction. They gained full passive ROM (0°-139.5°) in all knees.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique: Articulated External Fixator for Treatment of Complex Knee Dislocation

Marcacci

Zaffagnini

Bonanzinga

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 99%

Surgical Technique: Articulated External Fixator for Treatment of Complex Knee Dislocation

Marcacci

Zaffagnini

Bonanzinga

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Unfortunately, several authors failed to report their rate of secondary surgeries and/or reoperations[21,22,24]. The biggest problem we encountered after reconstructive surgery was continued pain and loss of motion.…”

Section: Discussionmentioning

confidence: 99%

“…In 2002, Ohkoshi et al reported good range of motion and antero-posterior laxity (KT-1000 manual maximum) after a two-stage surgical approach (first stage 2 weeks after injury: reconstruction of posterior cruciate ligament, second stage three months later: reconstruction of ligaments that have not healed as a result of non-surgical treatment). However, only eight patients were included in this series[24]. …”

Section: Discussionmentioning

confidence: 99%

“…In addition, allografts are hardly available in Europe. Synthetic grafts have occasionally been used in reconstructive surgery in patients with traumatic knee dislocations[24,30]. A series of 20 patients was evaluated retrospectively by Talbot et al with a minimum follow-up of one year, yielding inferior results in terms of the Lysholm score, range of motion and ligament laxity[30].…”

Section: Discussionmentioning

confidence: 99%

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Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

Hirschmann

Zimmermann

Rychen

et al. 2010

BMC Musculoskelet Disord

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BackgroundThe purpose of our study was to analyze the clinical and radiological long-term outcomes of surgically treated traumatic knee dislocations and determine prognostic factors for outcome.MethodsRetrospective consecutive series of patients treated surgically for traumatic knee dislocation with reconstruction/refixation of the anterior (ACL) and posterior cruciate ligaments (PCL) and primary complete repair of collaterals and posteromedial and posteromedial corner structures. 68 patients were evaluated clinically (IKDC score, SF36 health survey, Lysholm score, Knee Society score, Tegner score, visual analogue scale - VAS pain and satisfaction, Cooper test) and radiologically (weight bearing and stress radiographs) with a mean follow up of 12 ± 8 years. Instrumented anterior-posterior translation was measured (Rolimeter, KT-1000). Pearson correlation and stepwise regression analysis was used.Results82% of patients (n = 56) returned to their previous work. At final follow-up 6 patients (9%) suffered from pain VAS > 3. The mean side-to-side difference of anterior/posterior translation (KT-1000, 134N) was 1.6 ± 1.6 mm and 2.6 ± 1.4 mm. Valgus and varus stress testing in 30° flexion was <3 mm (normal) in 57 patients (86%). The IKDC score was normal/nearly normal in 38 (58%) patients and the mean Lysholm score 83 ± 17 (intact 98 ± 7). The median Tegner score decreased from 7 preinjury (range 3-10) to 5 at follow-up (range 0-10). The mean Knee Society score was 187 ± 15 (out of maximum 200). In 7 patients (10%) a secondary ligament reconstruction was performed. Three patients (4%) underwent a high tibial osteotomy and four (6%) received a primary unconstrained total knee replacement. According to the Kellgren Lawrence osteoarthritis score only mild degenerative changes were present. The stress radiographs showed stable results for anteroposterior translation. Injury of the lateral collateral ligament, refixation of the ACL/PCL and delayed surgery >40 days were significantly associated with worse outcome (p < 0.05).ConclusionsEarly complete reconstruction can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity. Negative predictive factors for outcome were injury pattern, type of surgical procedure and timing of surgery.

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“…The introduction of surgical treatment was later shown to be more effective than conservative treatment [2,3]. It began with the primary repair of the injured ligaments [4][5][6], then evolved into the era of reconstruction [7][8][9][10][11][12][13][14][15][16][17][18]. Surgical reconstruction is now the standard of care for most patients, although good results were recently achieved with repair [4].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of reconstructive surgery using artificial ligaments in 71 acute knee dislocations

Ranger

Renaud

Phan

et al. 2010

International Orthopaedics (SICOT)

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This retrospective study assessed the results of 71 patients with knee dislocations who underwent acute combined repair and reconstruction using Ligament Advancement Reinforcement System (LARS) artificial ligaments between June 1996 and May 2008 with a follow-up between two and eight years. The outcome measures used were the Lysholm score, the International Knee Documentation Committee form (IKDC 2000), the Tegner activity level score, the Meyers ratings, Telos stress radiography, range of motion and clinical knee stability testing. When comparing high-versus low-energy dislocations and knee dislocation (KD) II/III versus KD IV injuries, a better Lysholm score for the knee dislocation (KD) II/III group was found compared with the KD IV group. The subjective and objective findings from our study are satisfactory and comparable with the results of other studies of knee dislocations. Our findings suggest that with a mean follow-up of 54 months, acute combined repair and reconstruction with LARS ligaments is a valid alternative for treating knee dislocations.

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Two-Stage Reconstruction With Autografts for Knee Dislocations

Cited by 85 publications

References 11 publications

Surgical Technique: Articulated External Fixator for Treatment of Complex Knee Dislocation

Surgical Technique: Articulated External Fixator for Treatment of Complex Knee Dislocation

Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

Evaluation of reconstructive surgery using artificial ligaments in 71 acute knee dislocations

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