Arthroscopic Treatment for Obsolete Posterolateral Rotatory Dislocation of Knee Joint_West China Medical Journal

Authors：

 ChenGang , FuWeili , TangXin , LiQi ,  LiJian

Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LiJian, Email: 18980601388@163.com

Keywords：

Posterolateral rotatory dislocation; Knee; Arthroscopy

DOI：

10.7507/1002-0179.201600284

Video：

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Objective To explore the surgical treatment for neglected posterolateral rotatory dislocation of knee joint and evaluate the effect. Methods Sixteen patients with neglected knee posterolateral rotatory dislocation treated between January 2006 and December 2010 underwent surgical treatment. Arthroscopic lysis was first performed followed by open reduction, and then ligament reconstruction or repair was carried out in order to restore its stability. Some stiff knee joint patients underwent Patients with joint stiffness were fixed with external fixator across knee for six weeks. All the patients received preoperative and postoperative imaging examination and functional scoring. Results Tibiofemoral and patellofemoral congruence in all the 16 patients was fully restored. Joint stability was recovered with different degrees. Two patients underwent anterior cruciate ligament reconstruction and 1 underwent posterior cruciate ligament revision during the later stage, and their joint functional status at the end of follow-up was satisfying. Conclusion The treatment for neglected knee posterolateral rotatory dislocation by combined arthroscopy with open surgery is relatively satisfying, which is a new therapeutic approach for this type of injury.

Citation： ChenGang, FuWeili, TangXin, LiQi, LiJian. Arthroscopic Treatment for Obsolete Posterolateral Rotatory Dislocation of Knee Joint. West China Medical Journal, 2016, 31(6): 1057-1061. doi: 10.7507/1002-0179.201600284 Copy

1.	Said HG, Learmonth DJ. Chronic irreducible posterolateral knee dislocation: two-stage surgical approach[J]. Arthroscopy, 2007, 23(5): 564.e1-564.e4.
2.	Harb A, Lincoln D, Michaelson J. The MR dimple sign in irreducible posterolateral knee dislocations[J]. Skeletal Radiol, 2009, 38(11): 1111-1114.
3.	Richter M, Lobenhoffer P, Tscherne H. Knee dislocation. Long-term results after operative treatment[J]. Chirurg, 1999, 70(11): 1294- 1301.
4.	Wascher DC. High-velocity knee dislocation with vascular injury. Treatment principles[J]. Clin Sports Med, 2000, 19(3): 457-477.
5.	Capito N, Gregory MH, Volgas D, et al. Evaluation and management of an irreducible posterolateral knee dislocation[J]. J Knee Surg, 2013, 26(1): S136-S141.
6.	何銳, 楊柳, 郭林, 等. 急診關節鏡下清創復位聯合二期韌帶重建治療急性膝關節后外側旋轉脫位[J]. 中國骨科臨床與基礎研究雜志, 2012, 4(2): 102-109.
7.	肖瀟, 都仁斌. 切開復位治療膝關節后外側脫位[J]. 中國社區醫師, 2014, 30(9): 18-19.
8.	Urguden M, Bilbasar H, Ozenci AM, et al. Irreducible posterolateral knee dislocation resulting from a low-energy trauma[J]. Arthroscopy, 2004(20): S50-S52.
9.	Kilicoglu O, Akman S, Demirhan M, et al. Muscular buttonholing: an unusual cause of irreducible knee dislocation[J]. Arthroscopy, 2001, 17(6): E22.
10.	Kontakis GM, Christoforakis JJ, Katonis PG, et al. Irreducible knee dislocation due to interposition of the vastus medialis associated with neurovascular injury[J]. Orthopedics, 2003, 26(6): 645-646.
11.	Zhang H, Bai X, Sun Y, et al. Tibial inlay reconstruction of the medial collateral ligament using Achilles tendon allograft for the treatment of medial instability of the knee[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 22(2): 279-284.
12.	Noyes FR, Barber-Westin SD. Reconstruction of the anterior and posterior cruciate ligaments after knee dislocation. Use of early protected postoperative motion to decrease arthrofibrosis[J]. Am J Sports Med, 1997, 25(6): 769-778.
13.	Shapiro MS, Freedman EL. Allograft reconstruction of the anterior and posterior cruciate ligaments after traumatic knee dislocation[J]. Am J Sports Med, 1995, 23(5): 580-587.
14.	Ohkoshi Y, Nagasaki S, Shibata N, et al. Two-stage reconstruction with autografts for knee dislocations[J]. Clin Orthop Relat Res, 2002(398): 169-175.
15.	Shelbourne KD, Porter DA, Clingman JA, et al. Low-velocity knee dislocation[J]. Orthop Rev, 1991, 20(11): 995-1004.
16.	Van Thiel GS, Baker CL, Bush-Joseph C. A chronic posterolateral knee and patella dislocation: case report[J]. J Orthop Trauma, 2009, 23(7): 541-545.

1. Said HG, Learmonth DJ. Chronic irreducible posterolateral knee dislocation: two-stage surgical approach[J]. Arthroscopy, 2007, 23(5): 564.e1-564.e4.
2. Harb A, Lincoln D, Michaelson J. The MR dimple sign in irreducible posterolateral knee dislocations[J]. Skeletal Radiol, 2009, 38(11): 1111-1114.
3. Richter M, Lobenhoffer P, Tscherne H. Knee dislocation. Long-term results after operative treatment[J]. Chirurg, 1999, 70(11): 1294- 1301.
4. Wascher DC. High-velocity knee dislocation with vascular injury. Treatment principles[J]. Clin Sports Med, 2000, 19(3): 457-477.
5. Capito N, Gregory MH, Volgas D, et al. Evaluation and management of an irreducible posterolateral knee dislocation[J]. J Knee Surg, 2013, 26(1): S136-S141.
6. 何銳, 楊柳, 郭林, 等. 急診關節鏡下清創復位聯合二期韌帶重建治療急性膝關節后外側旋轉脫位[J]. 中國骨科臨床與基礎研究雜志, 2012, 4(2): 102-109.
7. 肖瀟, 都仁斌. 切開復位治療膝關節后外側脫位[J]. 中國社區醫師, 2014, 30(9): 18-19.
8. Urguden M, Bilbasar H, Ozenci AM, et al. Irreducible posterolateral knee dislocation resulting from a low-energy trauma[J]. Arthroscopy, 2004(20): S50-S52.
9. Kilicoglu O, Akman S, Demirhan M, et al. Muscular buttonholing: an unusual cause of irreducible knee dislocation[J]. Arthroscopy, 2001, 17(6): E22.
10. Kontakis GM, Christoforakis JJ, Katonis PG, et al. Irreducible knee dislocation due to interposition of the vastus medialis associated with neurovascular injury[J]. Orthopedics, 2003, 26(6): 645-646.
11. Zhang H, Bai X, Sun Y, et al. Tibial inlay reconstruction of the medial collateral ligament using Achilles tendon allograft for the treatment of medial instability of the knee[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 22(2): 279-284.
12. Noyes FR, Barber-Westin SD. Reconstruction of the anterior and posterior cruciate ligaments after knee dislocation. Use of early protected postoperative motion to decrease arthrofibrosis[J]. Am J Sports Med, 1997, 25(6): 769-778.
13. Shapiro MS, Freedman EL. Allograft reconstruction of the anterior and posterior cruciate ligaments after traumatic knee dislocation[J]. Am J Sports Med, 1995, 23(5): 580-587.
14. Ohkoshi Y, Nagasaki S, Shibata N, et al. Two-stage reconstruction with autografts for knee dislocations[J]. Clin Orthop Relat Res, 2002(398): 169-175.
15. Shelbourne KD, Porter DA, Clingman JA, et al. Low-velocity knee dislocation[J]. Orthop Rev, 1991, 20(11): 995-1004.
16. Van Thiel GS, Baker CL, Bush-Joseph C. A chronic posterolateral knee and patella dislocation: case report[J]. J Orthop Trauma, 2009, 23(7): 541-545.

West China Medical Journal

Arthroscopic Treatment for Obsolete Posterolateral Rotatory Dislocation of Knee Joint

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