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Mid-Term Results following Traumatic Knee Joint Dislocation

Purpose: Although treatment strategies of knee joint dislocations have evolved, there is still no consensus on the best method and timing. New therapeutic concepts suggest that early one-stage treatment, including suturing and bracing of the cruciate ligaments in acute knee joint dislocation, are le...

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Autores principales: Watrinet, Julius, von Rüden, Christian, Regenbogen, Stephan, Brand, Andreas, Bormann, Markus, Stuby, Fabian M., Fürmetz, Julian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821045/
https://www.ncbi.nlm.nih.gov/pubmed/36615066
http://dx.doi.org/10.3390/jcm12010266
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author Watrinet, Julius
von Rüden, Christian
Regenbogen, Stephan
Brand, Andreas
Bormann, Markus
Stuby, Fabian M.
Fürmetz, Julian
author_facet Watrinet, Julius
von Rüden, Christian
Regenbogen, Stephan
Brand, Andreas
Bormann, Markus
Stuby, Fabian M.
Fürmetz, Julian
author_sort Watrinet, Julius
collection PubMed
description Purpose: Although treatment strategies of knee joint dislocations have evolved, there is still no consensus on the best method and timing. New therapeutic concepts suggest that early one-stage treatment, including suturing and bracing of the cruciate ligaments in acute knee joint dislocation, are leading to improved functional results. This study aimed to evaluate the midterm functional outcome following traumatic knee joint dislocation and to determine whether the outcome is influenced by the surgical management, patient habitus or concomitant injuries. Methods: In this retrospective single center study, 38 patients with acute Schenck type II to IV knee dislocations were treated over an eight-year period in a level I trauma center. At follow-up, various clinical scores, such as the International Knee Documentation Committee (IKDC) Score, Lysholm Score, and Tegner Activity Scale (TAS), and individual questions about rehabilitation and activity levels of 38 patients were evaluated. Results: Mean follow-up was 5.5 ± 2.7 years. The mean IKDC Score was 65.6 ± 15.7 points, the average Lysholm Score was 70.5 ± 16.4 points and the median TAS was 4 (0–7), resulting in a loss of activity of 2 (range 0–6) points. There was no significant difference between a one-stage treatment compared to a two-stage approach. Ligament reconstruction of the ACL in a two-stage approach was required in only 33.3%. Further operations (early and late) were performed in 37% of cases. Being overweight was associated with more complications and worse outcomes, and external fixation with arthrofibrosis. Conclusions: Knee dislocation is a severe trauma that often leads to a prolonged loss of function and increased knee pain over years, affecting the patient’s activity. Clinical outcome is influenced significantly by concomitant injuries. Severe cases with initial external fixation are associated with a higher risk of knee stiffness and should be considered during rehabilitation. Obese patients present a challenge due to higher complication rates and lower postoperative knee function. Level of evidence: Retrospective single center study, level III.
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spelling pubmed-98210452023-01-07 Mid-Term Results following Traumatic Knee Joint Dislocation Watrinet, Julius von Rüden, Christian Regenbogen, Stephan Brand, Andreas Bormann, Markus Stuby, Fabian M. Fürmetz, Julian J Clin Med Article Purpose: Although treatment strategies of knee joint dislocations have evolved, there is still no consensus on the best method and timing. New therapeutic concepts suggest that early one-stage treatment, including suturing and bracing of the cruciate ligaments in acute knee joint dislocation, are leading to improved functional results. This study aimed to evaluate the midterm functional outcome following traumatic knee joint dislocation and to determine whether the outcome is influenced by the surgical management, patient habitus or concomitant injuries. Methods: In this retrospective single center study, 38 patients with acute Schenck type II to IV knee dislocations were treated over an eight-year period in a level I trauma center. At follow-up, various clinical scores, such as the International Knee Documentation Committee (IKDC) Score, Lysholm Score, and Tegner Activity Scale (TAS), and individual questions about rehabilitation and activity levels of 38 patients were evaluated. Results: Mean follow-up was 5.5 ± 2.7 years. The mean IKDC Score was 65.6 ± 15.7 points, the average Lysholm Score was 70.5 ± 16.4 points and the median TAS was 4 (0–7), resulting in a loss of activity of 2 (range 0–6) points. There was no significant difference between a one-stage treatment compared to a two-stage approach. Ligament reconstruction of the ACL in a two-stage approach was required in only 33.3%. Further operations (early and late) were performed in 37% of cases. Being overweight was associated with more complications and worse outcomes, and external fixation with arthrofibrosis. Conclusions: Knee dislocation is a severe trauma that often leads to a prolonged loss of function and increased knee pain over years, affecting the patient’s activity. Clinical outcome is influenced significantly by concomitant injuries. Severe cases with initial external fixation are associated with a higher risk of knee stiffness and should be considered during rehabilitation. Obese patients present a challenge due to higher complication rates and lower postoperative knee function. Level of evidence: Retrospective single center study, level III. MDPI 2022-12-29 /pmc/articles/PMC9821045/ /pubmed/36615066 http://dx.doi.org/10.3390/jcm12010266 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Watrinet, Julius
von Rüden, Christian
Regenbogen, Stephan
Brand, Andreas
Bormann, Markus
Stuby, Fabian M.
Fürmetz, Julian
Mid-Term Results following Traumatic Knee Joint Dislocation
title Mid-Term Results following Traumatic Knee Joint Dislocation
title_full Mid-Term Results following Traumatic Knee Joint Dislocation
title_fullStr Mid-Term Results following Traumatic Knee Joint Dislocation
title_full_unstemmed Mid-Term Results following Traumatic Knee Joint Dislocation
title_short Mid-Term Results following Traumatic Knee Joint Dislocation
title_sort mid-term results following traumatic knee joint dislocation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821045/
https://www.ncbi.nlm.nih.gov/pubmed/36615066
http://dx.doi.org/10.3390/jcm12010266
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