Treatment strategy and clinical outcome of knee dislocation / 中华骨科杂志

ABSTRACT

Objective To discuss the treatment strategy of knee dislocation and to evaluate its outcome.Methods Thirty-six patients with unilateral knee dislocation treated with individualized protocol were studied retrospectively,including 22 males and 14 females with an average age of 35 years (range,19-72 years).There were 30 acute and 6 chronic knee dislocations.According to the modified Schenck's classification of knee dislocation,there were 7 KD- Ⅰ and 23 KD-Ⅲ cases in the acute category,and all 6 chronic cases were KD-Ⅲ.Seven acute KD- Ⅰ and 6 chronic KD-Ⅲ cases underwent one-stage arthroscopic surgery.In 23 acute KD-Ⅲ cases,2 were treated conservatively with splint or brace due to advanced age,18 with staged surgery,3 with one-stage surgery due to concomitant vascular and nerve injury.Functional and clinical evaluation was conducted at final follow-up.Results All 36 patients were followed up for an average of 27 months (range,18-36 months).The Lysholm score (82.0±11.4),Tegner score (5.5±1.3),and knee range of motion (118.3°±19.2°) at final follow-up showed a statistically significant improvement compared with preoperative results (P＜O.O1).Eight (23.5％) patients had residual knee instabilityposterior drawer test and Sag sign were positive (++ or +++) in 8 knees,valgus instability (++) in 1 and varus instability (+++) in 1.The remaining 28 knees were stable.Conclusion Special attention should be paid to rotational knee dislocation with single cruciate ligament rupture.Properly individualized treatment plan is the key to optimal outcome.Arthroscopic surgery can lead to successful outcome.Early one-stage arthroscopic surgery is recommended for acute KD-Ⅰ and chronic KD-Ⅲ dislocation,staged arthroscopic surgery for acute KD-Ⅲ dislocation.