Knee -Pubmed Results

Chronic posterolateral knee dislocation with concurrent lateral patellar dislocation is a rare and challenging pathology. Without appropriate treatment, it invariably leads to advanced osteoarthritis, frequently necessitating total knee arthroplasty. However, achieving optimal patellofemoral tracking remains a primary challenge, and no consensus on a definitive surgical technique exists. In this article, we introduce a novel "Collar Tightening Technique" to address this complex clinical...

CONCLUSIONS: PLC and PLC combined with PMC injury showed similar prognostic effects, although the PLC group was numerically superior to the other group. We recommend primary repair and reconstruction in patients with confirmed PLC and PMC injuries to achieve the best postoperative recovery.

CONCLUSION: Knee disarticulation with femoral shortening osteotomy preserves the advantages of a knee disarticulation amputation and solves the historical problem of knee length difference with this amputation level.

CONCLUSION: Eight of the 36 (22.2 %) KSEF applications did not meet the predefined criteria for KSEF in the setting of KD, nor showed evidence of an inability to maintain tibiofemoral reduction via non-invasive means. Polytrauma is frequently cited in the literature as a primary indication for temporizing KSEF in the setting of KD without a clear definition. Further investigation into the role of temporizing KSEF is needed, particularly in the polytraumatized patient, to determine its specific...

CONCLUSION: Hexapod-assisted correction with patient-specific 3D osteotomy enabled successful joint preservation in chronic posttraumatic knee instability.

Acute management of a knee dislocation requires prompt recognition. A high index of suspicion should exist in any trauma patient with knee pain or an effusion. A thorough clinical examination to identify vascular or neurologic injury is critical. Reduction must be performed if the knee presents dislocated and open reduction is warranted if the knee is irreducible. Stabilization can occur with a splint or knee immobilizer, but if reduction is unable to be maintained, an external fixator should be...

Anterior tibial subluxation (ATS) in knee extension is observed in knees with anterior cruciate ligament (ACL) injuries. Preoperative ATS adversely affects the postoperative anterior stability and increases the risk of early graft failure. To investigate the factors associated with preoperative ATS in knees with ACL injury. A total of 191 patients who underwent primary ACL reconstruction between 2017 and 2022 were included. Preoperatively, all patients underwent lateral radiography with full...

CONCLUSIONS: Based on this systematic review, females experienced higher rates of recurrent dislocation and recorded worse PROMs following MPFL reconstruction.

No abstract

Congenital knee dislocation (CKD) is a rare condition; it occurs when the femoral condyle is posteriorly placed in relation to the proximal articular surface of the tibia. This displacement can happen in isolation or in association with other syndromes. Physical examination at birth is important in diagnosing CKD, with many classifications that guide its diagnosis and treatment. We report a case of a newborn male diagnosed with isolated right CKD. On examination, the diagnosis was confirmed as...

We present a case of a man in his 40s with a proximal tibiofibular joint dislocation, anterior cruciate ligament (ACL) tear and posterolateral corner (PLC) injury sustained after a cycling accident. Physical examination and MRI confirmed the diagnosis. He was treated with reconstruction of the ACL, PLC and proximal tibiofibular joint. Postoperative treatment included physical therapy to improve knee range of motion and full weight-bearing after 6 weeks. He was able to return to full activities...

CONCLUSIONS: Patients, whether undergoing LOA or not, performed equally well in terms of ROM and clinical scores at final follow up, while timing of LOA appears less critical. LOA is a simple, durable and safe method of treating ROM deficits in patients treated for acute knee dislocation, with very good results.

CONCLUSIONS: Early initiation of treatment is generally advised, as nonsurgical methods prove satisfactory for mild cases. However, surgical intervention should be considered in cases with severe stiffness, unresponsive outcomes to conservative treatment, persistent deformities, or diagnoses and treatments occurring beyond the first month after birth.

Patients with congenital dislocation of the knee (CDK) should be promptly treated surgically if conservative measures fail. This study aimed to achieve a better understanding of the diagnosis and management of CDK through sharing our experience and contributing to the existing literature. Nine patients with a total of 14 knees were included in the study. All patients except one were initially treated with gentle manipulation and serial casting. Surgery was performed on patients in whom...

CONCLUSION: Patients undergoing surgical management of KD3 injuries with true, documented KD had significantly worse clinical and functional outcomes than those with nondislocated joints at a mean 6.5-year follow-up. The current MLKI classification based solely on ligament involvement may be obscuring outcome research by not accounting for true dislocation.

CONCLUSIONS: We found a high aggregation of fracture-dislocations secondary to road traffic accidents. One in four patients experienced complications, particularly stiffness. Complications were more common in cases involving knee dislocation. Most patients had good functional results, but 25% were unable to return to their previous work, which demonstrates the long-lasting sequelae of this injury.

CONCLUSION: The knee function was well recovered after two-stage ligament reconstruction with remnant preservation.

After emergent assessment of potentially limb-threatening injuries in knee dislocation or multi-ligament knee injury patients, magnetic resonance imaging is necessary to visualize ligamentous structures and plan for soft tissue repair. However, the application of a knee-spanning external fixator may introduce artifact and reduce overall image quality, which can limit the evaluation of soft tissue injury. As a result, the utility of MRI in the context of a knee-spanning external fixator has been...

CONCLUSION: There remains substantial heterogeneity in the surgical techniques of acute, grade III PLC injuries with an overall failure rate of 12.4%. Failure rates were significantly lower, and return to sport rates higher in patients undergoing PLC reconstruction compared to repair. The most common postoperative complication was arthrofibrosis requiring manipulation under anesthesia.

A knee dislocation is a serious injury involving at least two of the four major ligamentous stabilizers of the knee. This injury results in multidirectional knee instability. In dislocation of the knee the popliteal artery and the peroneal nerve can also be damaged. Dislocations with vascular involvement are potentially threatening injuries of the lower extremities. The diagnosis of knee dislocation can be difficult due to a high rate of spontaneous reduction at the initial examination. Knee...

BACKGROUND: Knee dislocation (KD) is a rare but severe injury of the knee joint, with a high rate of concomitant neurovascular injuries. The severity of the ligamentous injury, which is classified according to the Schenck classification, the mechanism of injury, concomitant injuries and individual factors determine the treatment strategy in KD.

CONCLUSION: The utilization of this approach can prevent inappropriate graft tension and iatrogenic damage, reduce surgical time, and minimize airway complications by eliminating the need for the prone position. Optimizing these factors enhances the patient's chances for long-term outcomes; thus, surgeons should consider this approach in managing multiple-ligament knee injuries.

CONCLUSIONS: Using a modified Delphi technique, this study established consensus for specific fracture patterns to include within or exclude from the Schenck KD V subcategory.

No abstract

CONCLUSION: Meniscal repair using the outside-in technique can be effectively performed to improve the quality of life and the activity level of patients with acute meniscal tears.

CONCLUSIONS: Non-surgical treatment for acute medial meniscus posterior root tear did not result in any significant change in clinical outcomes from the initial to the final follow-up. The rate of conversion to arthroplasty was 13%, and the rate of osteoarthritis progression was 36%. Furthermore, subchondral insufficiency fracture was found to be a concomitant prognostic factor correlated with OA progression and conversion to arthroplasty. This information can provide insights for physicians...

CONCLUSION: ACLR provides superior translational stability than ACLIB in terms of instrumental testing and stress radiography. Both techniques were equivalent with respect to PROMS and led to good and excellent clinical results.

»: Traumatic knee dislocations are complex injuries that can be associated with compromise of the neurovascular structures about the knee.

BACKGROUND: Proximal tibiofibular joint (PTFJ) dislocation is a rare injury that can disrupt the proximal tibia-fibula joint. The abnormalities in knee x-ray imaging can be subtle and difficult to detect, requiring careful assessment. This rare cause of lateral knee pain requires a high level of suspicion for diagnosis. Treatment is closed reduction; unstable PTFJ dislocations often require surgical intervention.

A 48-year-old male patient presented with inner skin retraction after a sports accident involving the knee. In a multi-ligament injury it must be assumed that knee dislocation has occurred. Inner skin retraction after knee distortion can result from an intra-articular dislocation of the ruptured medial collateral ligament. Prompt reduction and exclusion of concomitant neurovascular injuries is thus obligatory. After surgical reconstruction of the medial collateral ligament, instability was no...

CONCLUSION: Early clinical diagnosis of irreducible knee dislocations and emergent open reduction should be performed to reduce the risk of soft-tissue compromise.

CONCLUSION: Acute, single-stage arthroscopic primary ligamentous repair is a viable option for high-grade multiligamentous knee dislocations and may be combined with our novel technique for arcuate fracture fixation.

INTRODUCTION: Multisystem injuries affecting vasculature and nerves can be detrimental sequelae of knee dislocations (KDs). The purpose of this study was to provide an update of the current literature since the conducted search used in the publication of Medina et al on May 3, 2013, to evaluate (1) the frequency of vascular and neurologic injury after KD, (2) the frequency with which surgical intervention was conducted for vascular injury in this setting, and (3) the frequency with which each...

CONCLUSIONS: The results of this retrospective study suggest that the new arthroscopic one-stage multi-ligament reconstruction technique is an effective way to treat Schenck IV knee dislocation with satisfactory postoperative knee function.

Ehlers-Danlos syndrome (EDS) causes joint hypermobility and joint dislocation. Since there are no reports of proximal tibiofibular joint (PTFJ) dislocation caused by EDS, little is known about the long-term course of this disease. A woman in her 40s presented with a posterolaterally depressed tibial condyle and severe valgus deformity caused by a long-standing PTFJ dislocation due to EDS. Considering the pathology, posterolateral open-wedge high tibial osteotomy (PLOWHTO) and medial closed-wedge...

Traumatic dislocation of the knee is a rare orthopaedic injury with often severe concomitant damage. In addition to the ligamentous injuries there is a significant risk of vascular injury, which can be potentially limb-threatening if undiagnosed or late recognized. It is therefore crucial with a correct and safe diagnostic method in the acute phase. Dislocation is caused by both high- and low-velocity mechanisms. Obesity is a single risk factor of low-velocity knee dislocation. Other than nerve...

CONCLUSION: Based on the findings of this SR we conclude that: the most common type of IKDs are PL dislocations, and the MCL, medial retinaculum and capsule and vastus medialis oblique form the most common structures involved in block to reduction and often will require open reduction and repair in acute setting if arthroscopic reduction fails. The most common pattern of injury to ligament is likely to be ACL, PCL, MCL±other structures but the MCL will be the most commonly repaired ligament. The...

Knee dislocation is a devastating form of multiligament injury of the knee. Due to its high complexity, there is a large number of different diagnostic and treatment strategies. With the aim of providing evidence-based treatment recommendations, the S2e guideline on knee dislocation is aimed at all professional groups involved in diagnostics and therapy (orthopaedic and trauma surgeons, physiotherapists, outpatient/inpatient surgeons, sports physicians, etc.) as well as those affected (patients...

CONCLUSION: With a mean follow-up of 6.5 years, combined repair and reconstruction surgery following a knee dislocation shows good to excellent patient-reported outcome and more than 75% of patients experiencing normal knee functioned evaluated by the IKDC score.

CONCLUSION: MRI has high accuracy for detecting tears of posterolateral corner stabilizers in the setting of acute KD. However, for grading structure integrity, the correlation of MRI with surgical findings is variable, ranging from fair to substantial.

This case highlights a staged operative approach for a patient who sustained bilateral knee dislocations and subsequent staged operative treatment and rehabilitation. This patient underwent bilateral multiligamentous knee reconstructions and left-sided peroneal nerve allografting because of complete peroneal nerve palsy. The initial treatment was bilateral medial collateral ligament reconstructions, posterolateral corner reconstructions, and capsular repairs with left leg peroneal nerve...

The management of unreduced knee dislocations who present late is challenging. The aim of this study was to determine the clinical, radiological, and functional outcomes following open reduction and reconstructive surgery for chronic irreducible knee dislocations. This retrospective study analyzed prospectively collected data of patients with an unreduced fixed anterior or posterior knee dislocation of 1 to 6 months' duration, treated with open reduction, hinged external fixator application, and...

CONCLUSION: PTFJD diagnosis requires appropriate images. Urgent close reduction is mandatory; if unsuccessful, open reduction, primary repair and internal fixation are indicated. The prognosis of spontaneous reduction remains uncertain and requires a serial clinical evaluation. In the case of recurrence, the appropriate surgical management is indicated according to the elapsed time from the injury.

The purpose of the present study was to describe the longitudinal outcomes of acute repair of extra-articular structure and anatomical reconstruction of cruciate ligament for knee dislocations (KDs) III and IV multiligamentous knee injuries. Forty-seven patients with an acute KD III or IV were treated with one-stage management within 9.2 days. Forty-five KDs III and IV with a follow-up at a mean of 53.2 months were evaluated. The mean International Knee Documentation Committee (IKDC) score,...

CONCLUSION: Consensus for inclusion of various factors in a KD classification system was not easily achieved. The wide geographic distribution of participants provides diverse insight and makes the results of the study globally applicable. The most important factors to include in a classification system as determined by the Delphi technique were vascular injuries, common peroneal nerve injuries, number of torn ligaments, and open injuries. To date, the Schenck anatomic classification system most...

Knee dislocations, aka multiligamentous injuries, are uncommon but devastating injuries often following high-energy trauma. Tears of the major knee stabilizers are well documented; however, injuries of the knee extensor mechanism are less commonly reported. The extensor mechanism is comprised of the patella, patellar tendon, and quadriceps tendons. Magnetic resonance imaging (MRI) is the preferred imaging modality of internal derangements of the knee due to its excellent soft tissue contrast. In...

Due to ligament laxity, bearing dislocation occurs in 1-6% of Oxford Domed Lateral (ODL) replacements with most dislocations occurring medially. Dislocations were studied using a previously built mechanical rig, however testing using the rig was inefficient. The aim of this study was to develop a better tool that was more reliable and efficient. An established robotics software package, the Open Motion Planning Library, was modified to accept the ODL components. Using a robotics path planning...

CONCLUSION: The promising effectiveness of KDMLI can obtain under the guidance of HX-KDMLI.

CONCLUSION: One-stage ACL, PCL, and PLC reconstruction combined with MCL repair to treat KD-Ⅳ knee dislocation can effectively restore knee joint stability, improve joint laxity, and improve joint movement.

CONCLUSION: Dislocation of the knee is an uncommon but life changing and potentially limb-threatening injury. It should always be suspected in trauma patients who present with multiligamentous knee injuries. The main concern is of neurovascular compromise to the lower leg, namely, the popliteal artery and common peroneal nerve. The treatment of multiligamentous knee injuries for most patients is surgical treatment with physiotherapy and adequate stabilization of the knee joint. Close monitoring...