Summary

Timing of surgery after the trauma statistically doesn’t influence the mid-term outcome, and one-stage repair and reconstruction of multiple ligament injuries of the knee offers good functional mid-term outcome.

Abstract

Introduction

Knee dislocations are very rare but manifest a variety of combinations of ligament injuries. Studies indicate that a one-stage procedure performed in the early stages after the injury can lead to superior results. Currently, there are contradictions regarding the best surgical method, timing and surgical staging.

Purpose

To evaluate mid-term clinical and functional outcomes of one-stage surgical treatment in acute and delayed surgery.

Materials And Methods

The study included 37 patients with III and IV Schenck type injury, who underwent surgery in 2012–2016. There were 16 (43%) cases of type III with medial ligament, 17 (46%) of type III with lateral ligament and 4 (11%) – type IV dislocations. 19 (51%) patients had acute and 18 (49%) delayed surgery. In the acute period, we performed lateral and posterior ligament repair and reconstruction of anterior, while delayed surgery included only ligaments reconstruction. The average age of patients at surgery was 38 years with the average follow-up 6.87 (5–8) years.

Results

Functional outcomes were evaluated by means of ROM and Lysholm scale. One-year follow-up showed better results in patients with delayed surgery: 120° (105–135) and 86 (78–92), 110º (90–125) and 80 (74–86). Two patients with acute surgery had arthrofibrosis that required arthroscopic release. But after 5 years of follow-up, there was no statistically significant difference in ROM and according to Lysholm scale – 120º (95–130) and 84 (76–92) in acute surgery, 125° (110–135) and 82 (72–90) in delayed surgery.

Conclusions

Timing of surgery after the trauma statistically doesn’t influence the mid-term outcome. One-stage repair and reconstruction of multiple ligament injuries of the knee offers good functional mid-term outcome.