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COMPLETE KNEE DISLOCATION – REVIEW OF OUR EXPERIENCE AND 6 YEARS FOLLOW-UP



Abstract

Purpose: Midterm follow up of complete knee dislocation and clinical outcome evaluation.

Materials and Methods: Between 1990–2004, we retrospectively reviewed the records of patients with complete knee dislocation. Eighteen patients, 19 knees were followed. Twelve males and 6 females. The average age at follow up was 40.7 years. Treatment consisted of primary knee stabilization with tutor cast in 10 knees and 9 by external fixation for 6 weeks. Following rehabilitation program, further surgical treatment was according to clinical relevancy. Functional and subjective evaluation was registered by the WOMAC questionnaire.

Results: Eleven were multiple trauma patients, involved in RTA, 2 had a crush injury, one patient involved in aviation accident had bilateral dislocation and 4 patients had low energy injury. Out of 7 patients, 8 knees had isolated dislocation. One died, 3 were not available for clinical follow up. Twelve patients returned the questionnaire. The average result of the WOMAC score was 46.5, range 7–91. Four knees presented advanced osteoarthritis with painful stiffness. Eight knees presented at the end of the follow up with instability as chief compliant. Five patients underwent later reconstructive procedures. One patient underwent knee arthrodesis.

Conclusion: In patients with knee dislocation, associated polytrauma should be regarded as a bed prognostic sign. The results suggest the need to revaluate the initial treatment strategy. The overall outcome shows that nearly all patients were able to perform daily activities, no patients in our study attempted any strenuous activity.

The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.