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Surgical management of knee dislocations
Christopher D Harner1, Robert L Waltrip, Craig H Bennett
1Center for Sports Medicine, 3200 South Water Street, Pittsburgh, PA 15203, USA. harnercd@msx.upmc.edu
The Journal of Bone and Joint Surgery. American Volume
|February 13, 2004
Summary
Surgical treatment of knee dislocations yields good outcomes, especially when performed acutely. Early intervention improves knee stability and subjective scores, though return to high-demand activities remains variable.
Area of Science:
- Orthopedic Surgery
- Knee Biomechanics
- Trauma Management
Background:
- Knee dislocation evaluation and management lack standardized protocols.
- Surgical treatment outcomes for knee dislocations are variable and debated.
- A standardized surgical approach aims to improve clinical results.
Purpose of the Study:
- To describe a standardized surgical protocol for knee dislocations.
- To report clinical outcomes following this standardized surgical treatment.
- To compare outcomes between acute and chronic knee dislocation repairs.
Main Methods:
- Thirty-three patients with knee dislocations underwent surgical repair using fresh-frozen allografts.
- Exclusion criteria included open dislocations, vascular injury, external fixation, or associated injuries.
- Patients were evaluated using four knee rating scales at a minimum of 24 months post-surgery.
Main Results:
- Nineteen patients had acute (<3 weeks) and twelve had chronic (≥3 weeks) repairs.
- Acute repairs showed higher Lysholm (91 vs. 80) and KOS-ADL (91 vs. 84) scores.
- Meyers ratings were excellent/good in 16/19 acute and 7/12 chronic repairs; improved stability noted in acute cases.
Conclusions:
- Standardized surgical treatment of knee dislocations provides satisfactory outcomes.
- Acute treatment (<3 weeks) leads to superior subjective and objective results compared to chronic treatment.
- Most patients regain function for daily activities, but return to high-demand sports is less predictable.