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Factors predictive of poorer outcomes in the surgical repair of multiligament knee injuries.

Alentorn-Geli, Eduard (författare)
Lazarides, Alexander L (författare)
Utturkar, Gangadhar M (författare)
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Myers, Heather S (författare)
Samuelsson, Kristian, 1977 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics
Choi, J H James (författare)
Stuart, Joseph J (författare)
Moorman, Claude T (författare)
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 (creator_code:org_t)
2018-08-06
2019
Engelska.
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 27:2, s. 445-459
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • To investigate the influence of injury and treatment factors on clinical/functional outcomes in multiligament knee injuries (MLKI).Thirty-nine consecutive patients with confirmed and surgically treated MLKI who met inclusion criteria were scheduled for a follow-up visit to obtain: SF-12 and subjective feeling of normalcy between the operated and healthy knee, and IKDC, active range of motion (ROM), and stability exam (Lachman test, posterior drawer, and dial test at 30°). A chart review was used to obtain data on injury and treatment factors.The postoperative mean (SD) outcomes were: IKDC score 62.7 (25.9), flexion-extension ROM 125° (29°), and percentage of normalcy 74% (20%). The postoperative normal/nearly normal stability exam was: Lachman test 36 (95%) patients, posterior drawer at 90° 38 (97%) patients, and dial test of 39 (100%) patients. There were 24 (61.5%) and 23 (59%) patients with complications and reoperations, respectively. The presence of bicruciate injuries was associated with worse Lachman (p=0.03) and posterior drawer tests (p=0.03). Presence of injury to meniscal structures was associated with worse Lachman test (p=0.03), lower percentage of normalcy (p=0.02) and extension lag (p=0.04). Injury to cartilage structures was associated with worse IKDC scores (p=0.04). IKDC was lower in cases of posterolateral corner reconstruction (p=0.03) and use of allograft tendons for reconstruction (p=0.02); ROM was lower in allograft reconstruction (p=0.02) and need for meniscal repair (p = 0.01). Bicruciate reconstruction led to worst posterior drawer test (p=0.006).The outcomes of MLKI might be negatively influenced by bicruciate ligament, meniscal, and cartilage injuries; with regards to treatment characteristics, need for posterolateral corner or bicruciate ligament reconstruction, use of allografts, or need for meniscal repair may similarly diminish outcomes. While surgical treatment provides good overall function, ROM and stability, it rarely results in a "normal" knee and the chances of complications and reoperations are high.Cross-sectional comparative study, Level III.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Nyckelord

Adult
Anterior Cruciate Ligament Reconstruction
statistics & numerical data
Cross-Sectional Studies
Female
Humans
Joint Instability
surgery
Knee Injuries
diagnosis
surgery
Knee Joint
surgery
Ligaments
surgery
Ligaments
Articular
injuries
surgery
Male
Meniscus
surgery
Middle Aged
Posterior Cruciate Ligament Reconstruction
statistics & numerical data
Postoperative Complications
Range of Motion
Articular
Reoperation
statistics & numerical data
Tendons
surgery
Transplantation
Homologous
Treatment Outcome

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