OBJECTIVES: To characterize multiligamentous knee injury patterns and describe associated morbidities. DESIGN: Retrospective. SETTING: Level I trauma center. PATIENTS: One hundred two patients (106 knees) with multiligamentous knee injuries and/or dislocations from 2000 through 2008. Subgroup of 82 knees with appropriate magnetic resonance images available assessed for ligamentous injury patterns. INTERVENTION: Data obtained from medical records for 106 knees. MAIN OUTCOME MEASUREMENTS: Presence of arterial injuries, nerve injuries, associated fracture patterns, and whole-body morbidities. RESULTS: The most common (43%) injury pattern was a combined disruption of the anterior cruciate ligament, posterior cruciate ligament, and posterolateral corner. Twenty-five percent of knees had associated ipsilateral tibial plateau fractures, and 19% had associated ipsilateral femoral fractures. Peroneal nerve injury occurred in 25% of knees, arterial injury in 21%, and compartment syndrome in 16%. An intra-abdominal injury was present in 13% of patients, a severe closed head injury in 10%, and a symptomatic pulmonary embolism in 5%. CONCLUSIONS: Nearly half the multiligamentous knee injuries involved the anterior cruciate ligament, posterior cruciate ligament, and posterolateral corner; one-fourth had associated ipsilateral tibial plateau fractures. The incidence of peroneal nerve injury (25%) was higher than previously reported (20%), whereas the incidence of arterial injury (21%) was comparable to previous reports (19%). Posterolateral corner injuries were more prevalent than previously reported and were highly associated with peroneal nerve injury. We found a substantial incidence of associated morbidities of the whole body. Multiligamentous knee injuries are a marker of concomitant trauma and should be closely evaluated at presentation and during the hospital course to allow for early intervention for life- or limb-threatening comorbidities.
OBJECTIVES: To characterize multiligamentous knee injury patterns and describe associated morbidities. DESIGN: Retrospective. SETTING: Level I trauma center. PATIENTS: One hundred two patients (106 knees) with multiligamentous knee injuries and/or dislocations from 2000 through 2008. Subgroup of 82 knees with appropriate magnetic resonance images available assessed for ligamentous injury patterns. INTERVENTION: Data obtained from medical records for 106 knees. MAIN OUTCOME MEASUREMENTS: Presence of arterial injuries, nerve injuries, associated fracture patterns, and whole-body morbidities. RESULTS: The most common (43%) injury pattern was a combined disruption of the anterior cruciate ligament, posterior cruciate ligament, and posterolateral corner. Twenty-five percent of knees had associated ipsilateral tibial plateau fractures, and 19% had associated ipsilateral femoral fractures. Peroneal nerve injury occurred in 25% of knees, arterial injury in 21%, and compartment syndrome in 16%. An intra-abdominal injury was present in 13% of patients, a severe closed head injury in 10%, and a symptomatic pulmonary embolism in 5%. CONCLUSIONS: Nearly half the multiligamentous knee injuries involved the anterior cruciate ligament, posterior cruciate ligament, and posterolateral corner; one-fourth had associated ipsilateral tibial plateau fractures. The incidence of peroneal nerve injury (25%) was higher than previously reported (20%), whereas the incidence of arterial injury (21%) was comparable to previous reports (19%). Posterolateral corner injuries were more prevalent than previously reported and were highly associated with peroneal nerve injury. We found a substantial incidence of associated morbidities of the whole body. Multiligamentous knee injuries are a marker of concomitant trauma and should be closely evaluated at presentation and during the hospital course to allow for early intervention for life- or limb-threatening comorbidities.
Authors: W A van der Wal; P J C Heesterbeek; T G van Tienen; V J Busch; J H M van Ochten; A B Wymenga Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-10-10 Impact factor: 4.342
Authors: Shane Cook; T J Ridley; Mark A McCarthy; Yubo Gao; Brian R Wolf; Annunziato Amendola; Matthew J Bollier Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-11-27 Impact factor: 4.342
Authors: M Tyrrell Burrus; Brian C Werner; Jourdan M Cancienne; Mark D Miller Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-07-28 Impact factor: 4.342