Summary
The short-term outcome of one-stage arthroscopic reduction combined with multi-ligament reconstruction or repair for irreducible posterolateral knee dislocation was satisfactory.
Abstract
Purpose
To evaluate the clinical outcomes after arthroscopic management of irreducible posterolateral knee dislocation.
Methods
From January 2009 to May 2014, 21 patients with irreducible posterolateral knee dislocation were treated in our institution. Inclusion criteria were (1) patients who underwent one-stage arthroscopic reduction combined with multi-ligament reconstruction or repair, and (2) with a minimum 2-year follow-up. Knee stability was assessed using physical examination, side-to-side differences (SSD) determined with KT-1000 arthrometer and Telos stress device. Other assessments included International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score and satisfaction rate.
Results
Thirteen of the 21 patients (8 male and 5 female) met our inclusion criteria and were included in this analysis. The mean age was 37.8 years (range, 27-56 years). The mean time from injury to surgery was 1.84 days (range, 1-3 days). The mean follow-up period was 32.6 months (range, 24-46 months). At final follow-up, except one patient who showed abnormal valgus stress test, all patients achieved normal or nearly normal Lachman test, pivot shift test, posterior drawer test, varus and valgus stress test. The mean SSD of total anterior-posterior translation and isolated anterior translation determined with KT-1000 arthrometer were 2.15 ± 1.57 mm (range, 0-6 mm) and 1.61 ± 0.86 mm (range, 1-4 mm), respectively. The mean SSD of anterior translation, posterior translation, medial and lateral joint gapping determined with Telos stress device were 2.23 ± 0.92 mm (range, 1-4 mm), 3.23 ± 1.16 mm (range, 2-5 mm), 1.77 ± 1.87 mm (range, 0-7 mm) and 0.46 ± 0.52 mm (range, 0-2 mm), respectively. The IKDC subjective score, Lysholm score and Tegner score improved significantly postoperatively (P=.001) with a satisfaction rate of 84.6%.
Conclusion
One-stage arthroscopic reduction combined with multi-ligament reconstruction or repair was an effective, reliable treatment for irreducible posterolateral knee dislocation.