CLINICAL OBSERVATION OF ONE-STAGE ARTHROSCOPIC RECONSTRUCTION AND STRICT IMMOBILIZATION FOR TREATMENT OF KNEE DISLOCATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MAMATKERIMULLA ,  XUGang , WANGXin , ZHANGYang , JIAYong , HUANGTao , XINGShuxing

Department of Joint Surgery, Urumqi General Hospital of Lanzhou Military Command, Urumqi Xinjiang, 830000, P. R. China;

Corresponding?author：

XUGang, Email: jxugang@sina.com

Keywords：

Knee joint dislocation; Ligament injury; Arthroscopy; Ligament reconstruction; Immobilization

DOI：

10.7507/1002-1892.20160083

Video：

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Objective To investigate the effectiveness of one-stage arthroscopic reconstruction and strict immobilization for 6 weeks for treatment of knee dislocation. Method Between August 2010 and May 2013, 22 cases (22 knees) of knee dislocation were treated with one-stage reconstruction and strict immobilization for 6 weeks. There were 15 males and 7 females, aged 21-54 years (mean, 31.5 years). The left knee and right knee were involved in 8 cases and 14 cases respectively. The disease causes were traffic accident in 12 cases, falling from height in 6 cases, and sports injury in 4 cases. The time between injury and operation was less than 2 weeks in 6 cases, 2-3 weeks in 10 cases, and more than 3 weeks in 6 cases. The results of anterior drawer test, posterior drawer test, and Lachman test were positive in all patients. The posterior displacement of the tibia was more than 10 mm. The results of valgus stress test and varus stress test were positive in 13 cases and 11 cases respectively. The preoperative knee range of motion was (58.2±28.4) °, Lysholm score was 39.7±4.6. All patients had anterior cruciate ligament rupture and posterior cruciate ligament rupture; combined injuries included medial collateral ligament rupture in 11 cases, lateral collateral ligament rupture in 9 cases, both medial and lateral collateral ligament rupture in 2 cases, femoral condylar avulsion fracture in 2 cases, and meniscus injury in 7 cases. No nerve or blood vessel injury was observed. Results All cases obtained primary healing of incision without infection. All the patients were followed up 12-48 months (mean, 27.8 months). At 12 months after operation, the results of the anterior drawer test, posterior drawer test, Lachman test, valgus stress test, and varus stress test were all negative; the knee range of motion increased was significantly to (121.3±7.9) °(t=30.061, P=0.000) ; Lysholm score was 87.2±6.1, showing significant difference when compared with preoperative score (t=24.642, P=0.000) . Conclusions A combination of arthroscopic one-stage reconstruction and strict immobilization for treatment of knee dislocation is a safe and effective method, good stability and joint function can be achieved.

Citation： MAMATKERIMULLA, XUGang, WANGXin, ZHANGYang, JIAYong, HUANGTao, XINGShuxing. CLINICAL OBSERVATION OF ONE-STAGE ARTHROSCOPIC RECONSTRUCTION AND STRICT IMMOBILIZATION FOR TREATMENT OF KNEE DISLOCATION. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(4): 412-415. doi: 10.7507/1002-1892.20160083 Copy

1.	段鑫, 楊勇, 肖國慶, 等. 關節鏡下修復重建膝關節脫位合并多發韌帶損傷的療效觀察. 中國修復重建外科雜志, 2008, 22(6) :673-675.
2.	Skendzel JG, Sekiya JK, Wojtys EM. Diagnosis and management of the mutiligament-injured knee. J Orthop Sports Phys Ther, 2012, 42(3) :234-242.
3.	Fanelli GC, Orcutt DR, Edson CJ. The multiple-1igament injured knee:evaluation, treatment, and results. Arthoscopy, 2005, 21(4) :47l-486.
4.	Kawano CT, Bispo RZ Jr, de Oliveira MG, et al. Posterolateral knee instability:an alternative proposal for surgical treatment. Clinics (Sao Paulo), 2007, 62(3) :371-374.
5.	O'Neil DB. Arthroscopically assisted reconstruction of the anterior cruciate ligament. A prospective randomized analysis of three techniques. J Bone Joint Surg (Am), 1996, 78(6) :803-813.
6.	Salzler MJ, Martin SD. All-arthroscopic anatomic repair of an avulsed popliteus tendon in a multiple ligament-injured knee. Orthopedics, 2012, 35(6) :e973-e976.
7.	Shon OJ, Lee DC, Park CH, et al. A comparison of arthroscopically assisted single and double bundle tibial inlay reconstruction for isolated posterior cruciate ligament injury. Clin Orthop Surg, 2010, 2(2) :76-84.
8.	張義龍, 李寧, 李志懷, 等. 自體與同種異體肌腱重建膝關節前交叉韌帶的比較. 中國組織工程研究與臨床康復, 2011, 15(31) :5743-5746.
9.	Bin SI, Nam TS. Surgical outcome of 2-stage management of multiple knee ligament injuries after knee dislocation. Arthroscopy, 2007, 23(10) :1066-1072.
10.	Subbiah M, Pandey V, Rao SK, et al. Staged arthroscopic reconstructive surgery for multiple ligament injuries of the knee. J Orthop Surg (Hong Kong), 2011, 19(3) :297-302.
11.	陳平泉, 朱振康, 王勝. 膝前、后交叉韌帶與內側副韌帶損傷的一期修復重建. 中國修復重建外科雜志, 2012, 26(6) :675-678.
12.	Shelbourne KD, Patel DV. Timing of surgery in anterior cruciate ligament-injured knees. Knee Surg Sports Trauma Arthros, 1995, 3(3) :148-156.
13.	Shelbourne KD, Fouk DA. Timing of surgery in acute anterior cruciate ligament tears on the return of quadriceps muscle strength after reconstruction using an autogenous patellar tendon graft. Am J Sports Med, 1995, 23(6) :686-689.
14.	于海洋, 翟云雷, 吳昊. 關節鏡下治療各型膝關節脫位的中期療效評價. 中華解剖與臨床雜志, 2014, 19(2) :138-142.
15.	王亦璁. 骨與關節損傷. 3版. 北京:人民衛生出版社, 2001:956-998.
16.	Peterson PK, Shelton WR, Bomboy AL. Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction:A 5-years follow-up. Arthroscopy, 2001, 17(1) :9-13.

1. 段鑫, 楊勇, 肖國慶, 等. 關節鏡下修復重建膝關節脫位合并多發韌帶損傷的療效觀察. 中國修復重建外科雜志, 2008, 22(6) :673-675.
2. Skendzel JG, Sekiya JK, Wojtys EM. Diagnosis and management of the mutiligament-injured knee. J Orthop Sports Phys Ther, 2012, 42(3) :234-242.
3. Fanelli GC, Orcutt DR, Edson CJ. The multiple-1igament injured knee:evaluation, treatment, and results. Arthoscopy, 2005, 21(4) :47l-486.
4. Kawano CT, Bispo RZ Jr, de Oliveira MG, et al. Posterolateral knee instability:an alternative proposal for surgical treatment. Clinics (Sao Paulo), 2007, 62(3) :371-374.
5. O'Neil DB. Arthroscopically assisted reconstruction of the anterior cruciate ligament. A prospective randomized analysis of three techniques. J Bone Joint Surg (Am), 1996, 78(6) :803-813.
6. Salzler MJ, Martin SD. All-arthroscopic anatomic repair of an avulsed popliteus tendon in a multiple ligament-injured knee. Orthopedics, 2012, 35(6) :e973-e976.
7. Shon OJ, Lee DC, Park CH, et al. A comparison of arthroscopically assisted single and double bundle tibial inlay reconstruction for isolated posterior cruciate ligament injury. Clin Orthop Surg, 2010, 2(2) :76-84.
8. 張義龍, 李寧, 李志懷, 等. 自體與同種異體肌腱重建膝關節前交叉韌帶的比較. 中國組織工程研究與臨床康復, 2011, 15(31) :5743-5746.
9. Bin SI, Nam TS. Surgical outcome of 2-stage management of multiple knee ligament injuries after knee dislocation. Arthroscopy, 2007, 23(10) :1066-1072.
10. Subbiah M, Pandey V, Rao SK, et al. Staged arthroscopic reconstructive surgery for multiple ligament injuries of the knee. J Orthop Surg (Hong Kong), 2011, 19(3) :297-302.
11. 陳平泉, 朱振康, 王勝. 膝前、后交叉韌帶與內側副韌帶損傷的一期修復重建. 中國修復重建外科雜志, 2012, 26(6) :675-678.
12. Shelbourne KD, Patel DV. Timing of surgery in anterior cruciate ligament-injured knees. Knee Surg Sports Trauma Arthros, 1995, 3(3) :148-156.
13. Shelbourne KD, Fouk DA. Timing of surgery in acute anterior cruciate ligament tears on the return of quadriceps muscle strength after reconstruction using an autogenous patellar tendon graft. Am J Sports Med, 1995, 23(6) :686-689.
14. 于海洋, 翟云雷, 吳昊. 關節鏡下治療各型膝關節脫位的中期療效評價. 中華解剖與臨床雜志, 2014, 19(2) :138-142.
15. 王亦璁. 骨與關節損傷. 3版. 北京:人民衛生出版社, 2001:956-998.
16. Peterson PK, Shelton WR, Bomboy AL. Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction:A 5-years follow-up. Arthroscopy, 2001, 17(1) :9-13.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL OBSERVATION OF ONE-STAGE ARTHROSCOPIC RECONSTRUCTION AND STRICT IMMOBILIZATION FOR TREATMENT OF KNEE DISLOCATION

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