Literature DB >> 27062009

Surgical Outcomes of Medial Versus Lateral Multiligament-Injured, Dislocated Knees.

Alexander H King1, Aaron J Krych1, Matthew R Prince1, Ayoosh Pareek1, Michael J Stuart1, Bruce A Levy2.   

Abstract

PURPOSE: To compare clinical and functional outcomes of surgically treated medial and lateral knee dislocations.
METHODS: A retrospective review of the medical records of patients who presented with knee dislocations was conducted. We identified patients who underwent surgical treatment of KDIII-M (anterior cruciate ligament/posterior cruciate ligament/medial collateral ligament) or KDIII-L (anterior cruciate ligament/posterior cruciate ligament/lateral collateral ligament) knee dislocation as documented by the Schenck classification. Minimum 2-year follow-up with Lysholm and International Knee Documentation Committee (IKDC) outcome scores was required for inclusion. Postoperative range of motion, ligamentous examination, and conversion to total knee arthroplasty were also collected. Data were analyzed using univariate and multivariate statistical models with P < .05 considered significant.
RESULTS: A total of 56 patients met the inclusion criteria, 24 with the KDIII-M injury pattern (43%) and 32 with the KDIII-L injury pattern (57%), with a mean age of 34 years (range, 16 to 62 years) and a mean follow-up of 6.5 years (range, 2 to 20 years). Patients undergoing medial repairs had worse outcomes for both the Lysholm score (P = .008) and IKDC score (P = .003). In addition, female sex was linked to worse outcomes (Lysholm score, 58.8 ± 21.5 v 77.8 ± 21.1, P < .01; IKDC score, 54.9 ± 23.7 v 75.2 ± 20.2, P < .01). No differences in outcome were found between patients with and patients without peroneal nerve injury (Lysholm score, P = .81; IKDC score, P = .77). No difference in laxity testing was found between the 2 groups.
CONCLUSIONS: In patients undergoing multiligament knee reconstruction, our data suggest that those who undergo medial repair for knee dislocations are not as likely to achieve positive results as those who undergo reconstruction or lateral reconstruction/repair, regardless of the status of the peroneal nerve. In addition, medial reconstruction had comparable outcomes to those in patients treated with lateral reconstruction/repair. Lastly, female patients showed less favorable clinical outcomes than male patients. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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Year:  2016        PMID: 27062009     DOI: 10.1016/j.arthro.2016.01.038

Source DB:  PubMed          Journal:  Arthroscopy        ISSN: 0749-8063            Impact factor:   4.772


  14 in total

Review 1.  Current Concepts and Controversies in Rehabilitation After Surgery for Multiple Ligament Knee Injury.

Authors:  Andrew D Lynch; Terese Chmielewski; Lane Bailey; Michael Stuart; Jonathan Cooper; Cathy Coady; Terrance Sgroi; Johnny Owens; Robert Schenck; Daniel Whelan; Volker Musahl; James Irrgang
Journal:  Curr Rev Musculoskelet Med       Date:  2017-09

2.  Poly-traumatic multi-ligament knee injuries: is the knee the limiting factor?

Authors:  Jarret M Woodmass; Nick R Johnson; Rohith Mohan; Aaron J Krych; Bruce A Levy; Michael J Stuart
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2017-11-29       Impact factor: 4.342

3.  Multiligament Reconstruction of the Knee in the Setting of Knee Dislocation With a Medial-Sided Injury.

Authors:  Marcio B Ferrari; Jorge Chahla; Justin J Mitchell; Gilbert Moatshe; Jacob D Mikula; Daniel Cole Marchetti; Robert F LaPrade
Journal:  Arthrosc Tech       Date:  2017-03-20

4.  The Posterolateral Instability Score (PoLIS) of the knee joint: a guideline for standardized documentation, classification, and surgical decision-making.

Authors:  Andreas Weiler; Karl-Heinz Frosch; Clemens Gwinner; Michael J Strobel; Philipp Lobenhoffer
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2020-05-27       Impact factor: 4.342

5.  Multi-ligament reconstructions as a risk factor for adverse outcomes in arthroscopic surgery.

Authors:  Justin Kyhos; Daniel Johnson; Bejan Alvandi; Michael Terry; Vehniah Tjong
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2020-09-09       Impact factor: 4.342

6.  Satisfactory knee function after single-stage posterolateral corner reconstruction in the multi-ligament injured/dislocated knee using the anatomic single-graft technique.

Authors:  Thomas L Sanders; Nick R Johnson; Ayoosh Pareek; Aaron J Krych; Robert G Marx; Michael J Stuart; Bruce A Levy
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2017-07-06       Impact factor: 4.342

7.  High return to play rate following treatment of multiple-ligament knee injuries in 136 elite athletes.

Authors:  Kyle A Borque; Mary Jones; Ganesh Balendra; Lukas Willinger; Vitor Hugo Pinheiro; Bobby Singh Anand; Andy Williams
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2022-03-13       Impact factor: 4.114

8.  Patient-Reported Outcomes After Multiligament Knee Injury: MCL Repair Versus Reconstruction.

Authors:  Jessica M Hanley; Christopher A Anthony; David DeMik; Natalie Glass; Annunziato Amendola; Brian R Wolf; Matthew Bollier
Journal:  Orthop J Sports Med       Date:  2017-03-15

9.  Long term outcome of early single stage surgery in multi-ligamentous injuries of knee.

Authors:  Ankit Goyal; Sanjeev Kumar; Pallav Mishra; Nitin Mehta; Deepak Joshi; Skand Sinha
Journal:  J Clin Orthop Trauma       Date:  2020-05-23

10.  Treatment of medial-sided injuries in patients with early bicruciate ligament reconstruction for knee dislocation.

Authors:  Mikko A Jokela; Tatu J Mäkinen; Mika P Koivikko; Joonas M Lindahl; Jyrki Halinen; Jan Lindahl
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2020-08-30       Impact factor: 4.342

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