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Management Of Acute Knee Dislocations: A Global Survey Of Orthopaedic Surgeons’ Strategies

2021 Congress Paper Abstracts

Management Of Acute Knee Dislocations: A Global Survey Of Orthopaedic Surgeons’ Strategies

Santa-Marie Venter, MMED(Ortho), MSc, MBChB, LLB, BA, SOUTH AFRICA Roopam Dey, PhD, SOUTH AFRICA Vikas Khanduja, MA(Cantab), MBBS, MSc, FRCS, FRCS(Orth), PhD, UNITED KINGDOM Richard P. von Bormann, MD, SOUTH AFRICA Michael Held, MD, PHD, SOUTH AFRICA

University of Cape Town, Cape Town, Western Cape, SOUTH AFRICA


2021 Congress   Abstract Presentation   6 minutes   Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Ligaments

PCL

Patient Populations

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Summary: This questionnaire based study shows that treatment of knee dislocations varied significantly based on the economic status of the country.


Purpose

The aim of this study was to compare the management approach of acute knee
dislocations (AKDs) by orthopaedic surgeons from nations with different economic status.

Methods

A survey sent to members of the Societe Internationale de Chirurgie Orthopedique et de Traumatologie (SICOT) compared different management strategies for acute multiligament knee injuries (aMLKIs). These were compared after categorising surgeons into developed economic nations (DEN) and emerging markets and developing nations (EMDN) based on the gross domestic product (GDP) per capita.

Results

138 orthopaedic surgeons from 47 countries participated in this study. DEN surgeons had more years of experience and were older (p<0.05). Surgeons from EMDN preferred conservative management and delayed reconstruction with autograft (p<0.05) if surgery was necessary. Surgeons from DEN favoured early, single stage arthroscopic ligament reconstruction. Significantly more EMDN surgeons preferred clinical examination (p<0.05) and duplex doppler scanning (p<0.05) compared to DEN surgeons. More surgeons from EMDN did not have access to a physiotherapist for their patients.

Conclusions

Treatment of aMLKIs varied significantly based on the economic status of the country. In EMDN, aMLKIs are often treated conservatively, ligament surgery is often delayed and staged, alternative vascular assessment methods are more commonly used, and access to physiotherapy is challenging. This calls for adjusted guidelines when treating patients in areas of low resource setting.


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