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TRAUMATIC DISLOCATION OF THE KNEE AND ITS MANAGEMENT

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Introduction Traumatic dislocation of knee is a complex injury challenging the skills of even the experienced surgeons. Our category of Traumatic dislocation of knee is combined ACL, PCL MCL ± other ligament injuries.

Aims and objectives 1. To accurately diagnose Multiliga-mentous Knee injuries. 2. To achieve optimal functional results in complex knee ligament injuries

Materials and Methods: We have treated 37 cases of multiligamentous knee injuries, The mechanism is low energy road traffic accident. Age range from 20 to 64 yrs.

Diagnosis by history and clinical tests (Drawers, valgus/Varus stress tests, rotary tests, recurvatum and Lachmann’s).

Investigations:- X-rays and MRI and Diganostic Arthroscopy. MRI

Is not routine. Isolated injuries are excluded from the study.

Surgery performed with in less than 1week of injury. In Chronic cases between 2–3 months Meticulous pre-op and skin Incision plan is necessary. Incisions were long oblique incision in the medial aspect for repair of the Postero medial complex, Medial collateral ligament and medial patellar retinaculae. Single incision techniques for primary ACL reconstruction with bone Patellar tendon bone graft,

Post –OP: Programmed physio protocol upto 3months.

Complications: Pain at the staple site was the most common problem. None warranted removal. No cases of subjective instability/pain was reported.

Post Op Assessment Average range of motion 120 degree achieved of 3 months. gentle nterior drawer’s / Lachmann’s / varus /valgus / stress test for laxity at 3 months and for instability at 6months.One leg hop test at 6 months.

Posterior drawers / were positive for all patients with PCL injury due to the delayed reconstruction.

Average follow-up of 15months

Lysholm knee score average of 84points,Keating’s knee score is average 82 on multiligamentous reconstructions of knee joint.

Conclusion: Excellent results achieved with staged Repair/Reconstruction with PCL at 2nd stage, all other ligaments as 1st stage.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.