gms | German Medical Science

Objectives: Traumatic knee dislocation is a rare but devastating injury. Several controversies persist over the type of treatment, including surgical timing, graft selection, repair versus reconstructive surgical techniques and postoperative rehabilitation. A novel technique for primary anterior cruciate ligament (ACL) repair, through dynamic intaligamentary stabilization (DIS), was developed at the authors' institution. For the current study, we analyzed the clinical outcomes of traumatic knee dislocations treated using a repair-based surgical approach; this involved application of the DIS technique for ACL repair, primary suturing of the medial collateral (MCL) and posterior cruciate ligaments (PCL), and repair or reconstruction of the lateral collateral ligament (LCL).

Methods: Between 2009 and 2012, 35 consecutive patients treated surgically for traumatic knee dislocation, with the technique mentioned above. They were evaluated clinically (International Knee Documentation Committee [IKDC] score, SF-12 health survey, Lysholm score, Tegner score, Instrumented anterior-posterior translation) and radiologically over a mean follow-up time period of 2.2 years years.

Results and Conclusion: The anterior drawer (KT-1000) of the healthy and injured limbs was 4.83 mm and 7.3 mm (89N) respectively. Valgus/varus stress testing in 30° flexion was clinically normal in 26 (74%)/ 29 (82%) patients, and close to normal in the rest of the patients. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6. The mean Lysholm score was 90.83 and the mean SF-12 physical and mental scores were 54.08 and 51, respectively. In two patients, a second procedure was necessary.

The less invasive surgical concept we propose for the management of traumatic knee dislocations spares the need for graft utility and presents comparably good results to the reconstruction-based gold standard.