Two-stage reconstruction with autografts for knee dislocations

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• Traumatic knee dislocations are severe injuries affecting multiple ligamentous structures.
• Current treatment methods for these complex injuries lack established protocols.
• Significant damage to anterior cruciate ligament, posterior cruciate ligament, and collateral ligaments necessitates advanced surgical intervention.

Purpose of the Study:

• To evaluate the clinical outcomes of a two-stage autologous reconstruction technique for traumatic knee dislocations.
• To assess the efficacy of arthroscopically assisted ligament reconstruction in severe knee injuries.
• To determine the functional recovery and stability achieved after multi-ligamentous knee reconstruction.

Main Methods:

• A two-stage surgical approach was employed for nine knees (eight patients) with traumatic dislocations.
• Stage one involved arthroscopic posterior cruciate ligament reconstruction using contralateral hamstring tendons.
• Stage two, performed three months later, included arthroscopic anterior cruciate ligament reconstruction and repair of other damaged ligaments (MCL, posterolateral structures) using autografts.

Main Results:

• All reconstructed knees achieved full extension and a mean passive flexion of 139.5 degrees.
• Mean side-to-side laxity difference was 2.3 mm, with no residual lateral or medial instability.
• Autograft reconstruction was successful for all injured ligaments, and severe contracture was prevented.

Conclusions:

• A two-stage autologous reconstruction is a viable and effective treatment for traumatic knee dislocations.
• This surgical strategy leads to good clinical outcomes, including restored range of motion and knee stability.
• The technique successfully addressed multi-ligamentous damage, preventing long-term complications like contracture.