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The acutely locked knee--is a manipulation worth while?

I J Critchley, D J Bracey

    Injury
    |January 1, 1985
    PubMed
    Summary
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    A locked knee often requires surgery after manipulation. Most patients with acute knee locking treated with manipulation under anesthesia needed further arthrotomy for internal derangement, particularly meniscus tears.

    Area of Science:

    • Orthopedic Surgery
    • Sports Medicine
    • Trauma Care

    Background:

    • Acute knee locking is a common presentation to emergency departments.
    • Manipulation under anesthesia is a traditional treatment approach.
    • Internal derangements, such as meniscus tears, can cause acute knee locking.

    Purpose of the Study:

    • To evaluate the effectiveness of manipulation under anesthesia for acute knee locking.
    • To determine the rate of subsequent surgical intervention required after manipulation.
    • To identify the types of internal derangements associated with acute knee locking.

    Main Methods:

    • A retrospective review of 85 consecutive patients with acute knee locking treated with manipulation under anesthesia over 10 years.
    • Follow-up assessment of 69 patients to determine outcomes and need for further treatment.

    Related Experiment Videos

  • Analysis of surgical findings in patients requiring arthrotomy.

    • Main Results:

    • 67% of followed patients (46/69) required arthrotomy for internal derangement.
    • Bucket-handle meniscus tears were the most common finding (41/46).
    • Only 33% of patients (23/69) achieved full recovery with manipulation alone.

    Conclusions:

    • Manipulation under anesthesia has a low success rate for acute knee locking.
    • A significant proportion of patients require surgical intervention, often for meniscus tears.
    • Immediate arthroscopy and potential surgical treatment may offer better outcomes for acute knee locking.