Maximiliano Scheu1, Gonzalo F Espinoza1, Carolina A Mellado2, Pedro A Díaz3, Alan F Garín1, Luis A O'Connell4,5. 1. Department of Orthopaedic Surgery, Hospital Clínico Mutual de Seguridad, Avenida Libertador Bernardo O'Higgins 4848, Santiago, Chile. 2. Department of Musculoskeletal Radiology, Hospital Clínico Mutual de Seguridad, Santiago, Chile. 3. Department of Orthopaedic Surgery, Hospital Clínico FUSAT, Rancagua, Chile. 4. Department of Orthopaedic Surgery, Hospital Clínico Mutual de Seguridad, Avenida Libertador Bernardo O'Higgins 4848, Santiago, Chile. luis.oconnell@gmail.com. 5. Servicio de Traumatología y Ortopedia, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Av Vitacura 5951, Santiago, Chile. luis.oconnell@gmail.com.
Abstract
PURPOSE: This study aims to identify multiple ligament knee injury patterns that possess a high-risk of vascular lesion. METHODS: We retrospectively compared torn ligament patterns and the presence of vascular lesions confirmed by magnetic resonance imaging and computed tomography angiography from 122 consecutive patients with diagnoses of multiple ligament knee injury made at the emergency department between January 2012 and December 2017. Patients were not eligible if they had an ipsilateral lower extremity lesion (dislocations or fractures at another level), initial evaluation at another hospital, or follow-up for less than 12 months. The primary outcomes were the comparison between the imaging findings of torn structures patterns and the presence of a vascular lesion. RESULTS: We identified 48 eligible patients (50 knees) with multiligamentary knee lesions, of whom eight had popliteal artery damage, yielding an incidence of 16%. Our clinical examination detected six of these patients that were classified, according to the Schenck system, as KD-IIIL (6 knees) and KD-IIIM (2 knees). The odds of having a popliteal artery injury is 4.69 to 1 with a KD-IIIL injury that with any other type of injury on that classification (95% CI 0.960-22.98). CONCLUSIONS: This data suggests that varus forces causing enough energy to produce a KD-IIIL lesion possess a higher popliteal artery injury risk, making recommendable a thorough examination of the vascular integrity when diagnosing a KD-IIIL lesion.
PURPOSE: This study aims to identify multiple ligament knee injury patterns that possess a high-risk of vascular lesion. METHODS: We retrospectively compared torn ligament patterns and the presence of vascular lesions confirmed by magnetic resonance imaging and computed tomography angiography from 122 consecutive patients with diagnoses of multiple ligament knee injury made at the emergency department between January 2012 and December 2017. Patients were not eligible if they had an ipsilateral lower extremity lesion (dislocations or fractures at another level), initial evaluation at another hospital, or follow-up for less than 12 months. The primary outcomes were the comparison between the imaging findings of torn structures patterns and the presence of a vascular lesion. RESULTS: We identified 48 eligible patients (50 knees) with multiligamentary knee lesions, of whom eight had popliteal artery damage, yielding an incidence of 16%. Our clinical examination detected six of these patients that were classified, according to the Schenck system, as KD-IIIL (6 knees) and KD-IIIM (2 knees). The odds of having a popliteal artery injury is 4.69 to 1 with a KD-IIIL injury that with any other type of injury on that classification (95% CI 0.960-22.98). CONCLUSIONS: This data suggests that varus forces causing enough energy to produce a KD-IIIL lesion possess a higher popliteal artery injury risk, making recommendable a thorough examination of the vascular integrity when diagnosing a KD-IIIL lesion.
Authors: Ryan S Marder; Husain Poonawala; Jorge I Pincay; Frank Nguyen; Patrick F Cleary; Christine S Persaud; Qais Naziri; Bashir A Zikria Journal: Orthop J Sports Med Date: 2021-10-13