nach oben

Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

21.03.2016 | Knee

Clinical outcomes after multiligament injured knees: medial versus lateral reconstructions

verfasst von: N. Tardy, P. Boisrenoult, P. Teissier, C. Steltzlen, P. Beaufils, N. Pujol

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was to analyse the clinical outcomes of multiligament injured knees with respect to the medial collateral ligament and posteromedial corner (PMC) repair or reconstruction versus the posterolateral corner (PLC) reconstruction in patients operated according to a codified surgical protocol.

Methods

Patients were divided into two groups depending on whether PMC or PLC was injured. Cruciate ligaments as well as PMC or PLC were reconstructed/repaired in a one-stage procedure. At minimum of 1-year follow-up, objective and subjective International Knee Documentation Committee (IKDC) forms, Lysholm score and sports activity level were recorded.

Results

Thirty-nine patients with a median follow-up time of 57 months (range 12–129) were reviewed. No significant difference was found for functional scores between acute PMC and PLC subgroups. In Group PLC, subjective outcomes tend to be better in the acute than in chronic reconstruction subgroup.

Conclusions

A one-stage protocol with early surgery rather than delayed reconstruction produced better clinical outcomes whatever the injured collateral ligament, medial or lateral. In the future, early and chronic reconstructions as well as each injury pattern should be considered as separate entities in studies on multiple ligament injured knees to reach a better level of evidence.

Level of evidence

IV.

Bin S-I, Nam T-S (2007) Surgical outcome of 2-stage management of multiple knee ligament injuries after knee dislocation. Arthroscopy 23(10):1066–1072CrossRefPubMed

Black BS, Stannard JP (2015) Repair versus reconstruction in acute posterolateral instability of the knee. Sports Med Arthrosc 23(1):22–26CrossRefPubMed

Bonanzinga T, Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, Neri MP, Marcacci M (2013) Management of combined anterior cruciate ligament-posterolateral corner tears: a systematic review. Am J Sports Med 42(6):1496–1503CrossRefPubMed

Brautigan B, Johnson DL (2000) The epidemiology of knee dislocations. Clin Sports Med 19(3):387–397CrossRefPubMed

Breitel D, Boisrenoult P, Leroux R, Beaufils P (2007) Plastie anatomique du point d’angle postérolatéral dans les lésions multiligamentaires du genou: résultats d’une série continue de 17 patients à court et moyen terme. Rev Chir Orthop Reparatrice Appar Mot 93(8):93–94CrossRef

Clark S, Engebretsen L (2011) Surgical treatment of acute knee dislocation. Tech Knee Surg 10:28–36CrossRef

Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM (2011) Measures of knee function: International Knee Documentation Committee (IKDC) subjective knee evaluation form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm knee scoring scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res 63(Suppl 11):208–228CrossRef

Cook S, Ridley TJ, McCarthy MA, Gao Y, Wolf BR, Amendola A, Bollier MJ (2015) Surgical treatment of multiligament knee injuries. Knee Surg Sports Traumatol Arthrosc 23(10):2983–2991CrossRefPubMed

DeLong JM, Waterman BR (2015) Surgical repair of medial collateral ligament and posteromedial corner injuries of the knee: a systematic review. Arthroscopy 31(11):2258–2272CrossRefPubMed

10.

Djian P (2015) Posterolateral knee reconstruction. Orthop Traumatol Surg Res 101:S159–S170CrossRefPubMed

11.

Dwyer T, Marx R, Whelan D (2012) Outcomes of treatment of multiple ligament knee injuries. J Knee Surg 25(4):317–326CrossRefPubMed

12.

Engebretsen L, Risberg MA, Robertson B, Ludvigsen TC, Johansen S (2009) Outcome after knee dislocations: a 2–9 years follow-up of 85 consecutive patients. Knee Surg Sports Traumatol Arthrosc 17(9):1013–1026CrossRefPubMed

13.

Fanelli GC, Edson CJ, Beck JD (2010) How I treat the multiple-ligament injured knee. Oper Tech Sports Med 18(4):198–210CrossRef

14.

Fanelli GC, Stannard JP, Stuart MJ, Macdonald PB, Marx RG, Whelan DB, Boyd JL, Levy BA (2011) Management of complex knee ligament injuries. Instr Course Lect 60:523–535PubMed

15.

Frosch K-H, Preiss A, Heider S, Stengel D, Wohlmuth P, Hoffmann MF, Lill H (2013) Primary ligament sutures as a treatment option of knee dislocations: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 21(7):1502–1509CrossRefPubMed

16.

Gwathmey FW, Tompkins MA, Gaskin CM, Miller MD (2012) Can stress radiography of the knee help characterize posterolateral corner injury? Clin Orthop 470(3):768–773CrossRefPubMed

17.

Halewood C, Amis AA (2015) Clinically relevant biomechanics of the knee capsule and ligaments. Knee Surg Sports Traumatol Arthrosc 23:2789–2796CrossRefPubMed

18.

Harner CD, Waltrip RL, Bennett CH, Francis KA, Cole B, Irrgang JJ (2004) Surgical management of knee dislocations. J Bone Joint Surg Am 86-A(2):262–273CrossRefPubMed

19.

Hefti E, Müller W, Jakob RP, Stäubli H-U (1993) Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc 1(3–4):226–234CrossRefPubMed

20.

Howells NR, Brunton LR, Robinson J, Porteus AJ, Eldridge JD, Murray JR (2011) Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury 42(11):1198–1204CrossRefPubMed

21.

Ibrahim SAR, Ghafar S, Salah M, Abo Alnas M, Al Misfer A, Farouk H, Al Haran H, Khirait S (2013) Surgical management of traumatic knee dislocation with posterolateral corner injury. Arthroscopy 29(4):733–741CrossRefPubMed

22.

James EW, LaPrade CM, LaPrade RF (2015) Anatomy and biomechanics of the lateral side of the knee and surgical implications. Sports Med Arthrosc Rev 23(1):2–9CrossRef

23.

Jiang W, Yao J, He Y, Sun W, Huang Y, Kong D (2015) The timing of surgical treatment of knee dislocations: a systematic review. Knee Surg Sports Traumatol Arthrosc 23(10):3108–3113CrossRefPubMed

24.

Kovachevich R, Shah JP, Arens AM, Stuart MJ, Dahm DL, Levy BA (2009) Operative management of the medial collateral ligament in the multi-ligament injured knee: an evidence-based systematic review. Knee Surg Sports Traumatol Arthrosc 17(7):823–829CrossRefPubMed

25.

Krych AJ, Sousa PL, King AH, Engasser WM, Stuart MJ, Levy BA (2015) Meniscal tears and articular cartilage damage in the dislocated knee. Knee Surg Sports Traumatol Arthrosc 23:3019–3025CrossRefPubMed

26.

Kupczik F, Schiavon MEG, Vieira L de A, Tenius DP, Favaro RC, Kupczik F, Schiavon MEG, Vieira L de A, Tenius DP, Favaro RC (2013) Knee dislocation: descriptive study of injuries. Rev Bras Ortop 48:145–151CrossRef

27.

Laprade RF, Wijdicks CA (2012) Surgical technique: development of an anatomic medial knee reconstruction. Clin Orthop 470(3):806–814CrossRefPubMed

28.

Leroux R, Guillon P, Boisrenoult P, Charrois O, Beaufils P (2004) Reconstruction anatomique du plan postéro-latéral du genou à l’aide d’un transplant unique: à propos de 12 cas. Rev Chir Orthop Reparatrice Appar Mot 90(Suppl 6):294

29.

Levy BA, Dajani KA, Morgan JA, Shah JP, Dahm DL, Stuart MJ (2010) Repair versus reconstruction of the fibular collateral ligament and posterolateral corner in the multiligament-injured knee. Am J Sports Med 38(4):804–809CrossRefPubMed

30.

Levy BA, Dajani KA, Whelan DB, Stannard JP, Fanelli GC, Stuart MJ, Boyd JL, MacDonald PA, Marx RG (2009) Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy 25(4):430–438CrossRefPubMed

31.

Levy BA, Fanelli GC, Whelan DB, Stannard JP, MacDonald PA, Boyd JL, Marx RG, Stuart MJ, Knee Dislocation Study Group (2009) Controversies in the treatment of knee dislocations and multiligament reconstruction. J Am Acad Orthop Surg 17(4):197–206CrossRefPubMed

32.

Li X, Liu T (2013) Surgical management of multiple knee ligament injuries. Eur J Orthop Surg Traumatol 23(6):691–697CrossRefPubMed

33.

Mabvuure NT, Malahias M, Haddad B, Hindocha S, Khan WS (2014) State of the art regarding the management of multiligamentous injuries of the knee. Open Orthop J 8:215–218CrossRefPubMedPubMedCentral

34.

McKee L, Ibrahim MS, Lawrence T, Pengas IP, Khan WS (2014) Current concepts in acute knee dislocation: the missed diagnosis? Open Orthop J 8:162–167CrossRefPubMedPubMedCentral

35.

Meyers MH, Moore TM, Harvey JP (1975) Traumatic dislocation of the knee joint. J Bone Joint Surg Am 57(7):430–433CrossRefPubMed

36.

Mook WR, Miller MD, Diduch DR, Hertel J, Boachie-Adjei Y, Hart JM (2009) Multiple-ligament knee injuries: a systematic review of the timing of operative intervention and postoperative rehabilitation. J Bone Joint Surg Am 91(12):2946–2957CrossRefPubMed

37.

Omar M, Petri M, Dratzidis A, El Nehmer S, Hurschler C, Krettek C, Jagodzinski M, Ettinger M (2014) Biomechanical comparison of fixation techniques for medial collateral ligament anatomical augmented repair. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3326-5 PubMed

38.

Peskun CJ, Levy BA, Fanelli GC, Stannard JP, Stuart MJ, MacDonald PB, Marx RG, Boyd JL, Whelan DB (2010) Diagnosis and management of knee dislocations. Phys Sportsmed 38(4):101–111CrossRefPubMed

39.

Ranger P, Renaud A, Phan P, Dahan P, De Oliveira E, Delisle J (2011) Evaluation of reconstructive surgery using artificial ligaments in 71 acute knee dislocations. Int Orthop 35(10):1477–1482CrossRefPubMed

40.

Schenck RC (1994) The dislocated knee. Instr Course Lect 43:127–136PubMed

41.

Schenck RC, Richter DL, Wascher DC (2014) Knee dislocations lessons learned from 20-year follow-up. Orthop J Sports Med 2(5):2325967114534387CrossRefPubMedPubMedCentral

42.

Seroyer ST, Musahl V, Harner CD (2008) Management of the acute knee dislocation: the Pittsburgh experience. Injury 39(7):710–718CrossRefPubMed

43.

Smyth MP, Koh JL (2015) A review of surgical and nonsurgical outcomes of medial knee injuries. Sports Med Arthrosc 23(2):15–22CrossRef

44.

Subbiah M, Pandey V, Rao SK, Rao S (2011) Staged arthroscopic reconstructive surgery for multiple ligament injuries of the knee. J Orthop Surg (Hong Kong) 19(3):297–302CrossRef

45.

Suh JT, Ahn JM, Lee JM, Kim NR (2014) Staged surgical management of multiple ligament injury of the knee. Arthrosc Orthop Sports Med 1:111–119CrossRef

46.

Sullivan JP, McCarthy M, Marx RG (2015) Outcomes for surgical treatment of posterolateral instability of the knee. Sports Med Arthrosc 23(1):55–59CrossRefPubMed

47.

Wascher DC, Dvirnak PC, DeCoster TA (1997) Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma 11(7):525–529CrossRefPubMed

48.

Werner BC, Hadeed MM, Gwathmey FW, Gaskin CM, Hart JM, Miller MD (2014) Medial injury in knee dislocations: what are the common injury patterns and surgical outcomes? Clin Orthop Relat Res 472(9):2658–2666CrossRefPubMedPubMedCentral

49.

Wijdicks CA, Michalski MP, Rasmussen MT, Goldsmith MT, Kennedy NI, Lind M, Engebretsen L, LaPrade RF (2013) Superficial medial collateral ligament anatomic augmented repair versus anatomic reconstruction: an in vitro biomechanical analysis. Am J Sports Med 41(12):2858–2866CrossRefPubMed

50.

Wong C-H, Tan J-L, Chang H-C, Khin L-W, Low C-O (2004) Knee dislocations-a retrospective study comparing operative versus closed immobilization treatment outcomes. Knee Surg Sports Traumatol Arthrosc 12(6):540–544CrossRefPubMed

51.

Yang BS, Bae WH, Ha JK, Lee DW, Jang HW, Kim JG (2013) Posterolateral corner reconstruction using the single fibular sling method for posterolateral rotatory instability of the knee. Am J Sports Med 41(7):1605–1612CrossRefPubMed

Titel: Clinical outcomes after multiligament injured knees: medial versus lateral reconstructions
verfasst von: N. Tardy
P. Boisrenoult
P. Teissier
C. Steltzlen
P. Beaufils
N. Pujol
Publikationsdatum: 21.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 2/2017
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-016-4067-4

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Clinical outcomes after multiligament injured knees: medial versus lateral reconstructions

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Update Orthopädie und Unfallchirurgie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2017

Biomechanical comparison of graft structures in anterior cruciate ligament reconstruction

Validation of the updated ArthroS simulator: face and construct validity of a passive haptic virtual reality simulator with novel performance metrics

Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up

Impact of surgical timing on the outcome of anterior cruciate ligament reconstruction

Does sterilization with fractionated electron beam irradiation prevent ACL tendon allograft from tissue damage?

The difficult balance between scientific evidence and clinical practice: the 2016 ESSKA meniscus consensus on the surgical management of degenerative meniscus lesions

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Update Orthopädie und Unfallchirurgie