Journal article
Dynamic intraligamentary stabilization and primary repair: a new concept for the treatment of knee dislocation.
- Kohl S Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
- Stock A Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
- Ahmad SS Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
- Zumstein M Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
- Keel M Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
- Exadaktylos A Department of Emergency Medicine, University of Bern, Switzerland.
- Kohlhof H Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
- Eggli S Sonnenhof Orthopaedic Clinics, Bern, Switzerland.
- Evangelopoulos DS Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland; 3rd Department of Orthopaedic Surgery, KAT Hospital, University of Athens, Greece. Electronic address: ds.evangelopoulos@gmail.com.
- 2014-12-03
Published in:
- Injury. - 2015
Acute ligament repair
Dislocation
Dynamic intraligamentary stabilization
Knee
Adolescent
Adult
Anterior Cruciate Ligament
Anterior Cruciate Ligament Injuries
Anterior Cruciate Ligament Reconstruction
Female
Follow-Up Studies
Fracture Healing
Humans
Knee Dislocation
Male
Middle Aged
Patient Satisfaction
Range of Motion, Articular
Recovery of Function
Suture Techniques
Trauma Severity Indices
Treatment Outcome
English
BACKGROUND
Traumatic knee dislocation represents a rare but devastating injury. Several controversies persist regarding type of treatment, surgical timing, graft selection, repair versus reconstruction of the medial and lateral structures, surgical techniques and postoperative rehabilitation. A new technique for primary ACL stabilization, dynamic intaligamentary stabilization (DIS) was developed at the authors' institution. The purpose of this study was to analyze the clinical and radiological outcomes of surgically treated traumatic knee dislocations by means of the DIS technique for the ACL, primary suturing for PCL, MCL and LCL.
METHODS
Between 2009 and 2012, 35 patients treated surgically for traumatic knee dislocation with primary anterior cruciate ligament (ACL) reconstruction with DIS, suturing of the posterior cruciate ligament (PCL) and primary complete repair of collaterals, were evaluated clinically (IKDC score, SF12 health survey, Lysholm score, Tegner score) and radiologically with a mean follow up of 2.2 years (range 1.00-3.50 years) years. Instrumented anterior-posterior translation was measured (KT-2000).
RESULTS
Anterior/posterior translation (KT-2000) for the healthy and injured limb was 4.8mm (range 3-8mm) and 7.3mm (range 5-10) (89N) respectively. Valgus and varus stress testing in 30° flexion was normal in 26 (75%) and 29 (83%) patients, respectively. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6 (range 4-8). The mean Lysholm score was 90.83 (range 81-95) and mean SF-12 physical and mental scores were 54.1 (range 45-60) and 51.0 (range 39-62) respectively. In 2 patients, a secondary operation was performed.
CONCLUSIONS
Early, one stage reconstruction with DIS can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity without graft requirements.
Traumatic knee dislocation represents a rare but devastating injury. Several controversies persist regarding type of treatment, surgical timing, graft selection, repair versus reconstruction of the medial and lateral structures, surgical techniques and postoperative rehabilitation. A new technique for primary ACL stabilization, dynamic intaligamentary stabilization (DIS) was developed at the authors' institution. The purpose of this study was to analyze the clinical and radiological outcomes of surgically treated traumatic knee dislocations by means of the DIS technique for the ACL, primary suturing for PCL, MCL and LCL.
METHODS
Between 2009 and 2012, 35 patients treated surgically for traumatic knee dislocation with primary anterior cruciate ligament (ACL) reconstruction with DIS, suturing of the posterior cruciate ligament (PCL) and primary complete repair of collaterals, were evaluated clinically (IKDC score, SF12 health survey, Lysholm score, Tegner score) and radiologically with a mean follow up of 2.2 years (range 1.00-3.50 years) years. Instrumented anterior-posterior translation was measured (KT-2000).
RESULTS
Anterior/posterior translation (KT-2000) for the healthy and injured limb was 4.8mm (range 3-8mm) and 7.3mm (range 5-10) (89N) respectively. Valgus and varus stress testing in 30° flexion was normal in 26 (75%) and 29 (83%) patients, respectively. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6 (range 4-8). The mean Lysholm score was 90.83 (range 81-95) and mean SF-12 physical and mental scores were 54.1 (range 45-60) and 51.0 (range 39-62) respectively. In 2 patients, a secondary operation was performed.
CONCLUSIONS
Early, one stage reconstruction with DIS can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity without graft requirements.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.injury.2014.10.012
- PMID 25456494
- Persistent URL
- https://sonar.ch/global/documents/140203
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