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Multiligament knee

Philip L Wilson, Charles W Wyatt, Jose Romero, Meagan J Sabatino, Henry B Ellis
Background: Despite the increasing incidence of sports-related knee injuries in youth athletes, few studies have reported on the diagnosis and treatment of pediatric and adolescent meniscal root injuries. Purpose: To describe traumatic posterior meniscal root injuries in a pediatric and adolescent population and compare the presentation of meniscal root injuries versus that of nonroot injuries. Study Design: Cohort study; Level of evidence, 3...
November 2018: Orthopaedic Journal of Sports Medicine
A Achtnich, A Schmitt, P Forkel, A B Imhoff, K Beitzel
OBJECTIVE: The aim of arthroscopic bracing of the posterior cruciate ligament (PCL) is to restore anatomic and biomechanic function in acute PCL tears. Therefore, primary augmentation of the PCL by using a stable suturing system is used. INDICATIONS: Acute tears of the PCL, femoral avulsions, isolated or combined in cases of multiligament injuries (knee dislocations of Schenk types II-IV). CONTRAINDICATIONS: Chronic instabilities of the PCL, infection of the knee joint...
November 26, 2018: Operative Orthopädie und Traumatologie
Brian M Devitt, Ruchith Dissanayake, Joseph Clair, Richard J Napier, Tabitha J Porter, Julian A Feller, Kate E Webster
Background: Although isolated posterior cruciate ligament reconstruction (PCLR) has become a more frequently performed procedure, reports of functional outcomes and return-to-sport (RTS) rates to support its use are still limited. Purpose: To systematically review the literature to determine the rates of RTS and the functional outcomes of patients after isolated PCLR. Study Design: Systematic review: Level of evidence, 4. Methods: Two reviewers independently searched 5 databases for patient-based clinical studies with a minimum 2-year follow-up that analyzed functional outcome and RTS following isolated PCLR...
October 2018: Orthopaedic Journal of Sports Medicine
Eric Hamrin Senorski, David Sundemo, Eleonor Svantesson, Ninni Sernert, Jüri-Toomas Kartus, Jón Karlsson, Kristian Samuelsson
PURPOSE: To determine preoperative predictors of long-term acceptable knee function and the development of osteoarthritis (OA) in long-term follow-up after anterior cruciate ligament (ACL) reconstruction. METHODS: This study is a long-term follow-up of 2 previous randomized controlled trials that included 193 patients who underwent unilateral ACL reconstruction with ipsilateral hamstring tendon or patellar tendon autografts. Patients who suffered multiligament injuries, major meniscal injuries, chondral lesions requiring surgical treatment, or had a previous ACL reconstruction were excluded...
October 6, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Eduard Alentorn-Geli, Alexander L Lazarides, Gangadhar M Utturkar, Heather S Myers, Kristian Samuelsson, J H James Choi, Joseph J Stuart, Claude T Moorman
The author would like to correct the following errors in the publication of the original article.
September 19, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Anne Jonkergouw, Jelle P van der List, Gregory S DiFelice
Knee dislocations often result in a severe multiligament injured knee (MLIK) with complex instability. Multiligament reconstruction can successfully restore knee stability and is commonly recommended, although surgical morbidity is induced by graft harvesting and tunnel drilling, and convergence of multiple tunnels can complicate the surgery. Therefore, as an alternative, primary repair of knee ligaments is currently reconsidered. The main advantages of primary repair consist of tissue preservation and decrease of surgical morbidity, which might improve knee functionality...
August 2018: Arthroscopy Techniques
Eduard Alentorn-Geli, Alexander L Lazarides, Gangadhar M Utturkar, Heather S Myers, Kristian Samuelsson, J H James Choi, Joseph J Stuart, Claude T Moorman
PURPOSE: To investigate the influence of injury and treatment factors on clinical/functional outcomes in multiligament knee injuries (MLKI). METHODS: Thirty-nine consecutive patients with confirmed and surgically treated MLKI who met inclusion criteria were scheduled for a follow-up visit to obtain: SF-12 and subjective feeling of normalcy between the operated and healthy knee, and IKDC, active range of motion (ROM), and stability exam (Lachman test, posterior drawer, and dial test at 30°)...
August 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Peter D Fabricant, Frances A Tepolt, Mininder S Kocher
BACKGROUND: Arthrofibrosis of the knee is well-described in adults as a potentially debilitating postoperative complication following anterior cruciate ligament reconstruction, total knee arthroplasty, or fracture fixation. Knee arthrofibrosis in children and adolescents, however, has received little attention. The primary purpose of this study was to report improvements in range of motion (ROM) following lysis of adhesions and manipulation under anesthesia (LOA/MUA) in children and adolescents with knee arthrofibrosis, and, secondarily, to evaluate for any effect of preoperative dynamic splinting on ROM outcomes...
October 2018: Journal of Pediatric Orthopedics
John R Worley, Olubusola Brimmo, Clayton W Nuelle, James L Cook, James P Stannard
The purpose of this study was to determine incidence of concurrent peroneal nerve injury and to compare outcomes in patients with and without peroneal nerve injury after surgical treatment for multiligament knee injuries (MLKIs). A retrospective study of 357 MLKIs was conducted. Patients with two or more knee ligaments requiring surgical reconstruction were included. Mean follow-up was 35 months (0-117). Incidence of concurrent peroneal nerve injury was noted and patients with and without nerve injury were evaluated for outcomes...
June 13, 2018: Journal of Knee Surgery
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies...
February 2018: Arthroscopy Techniques
Zhuo Hongwu, Jian Li
The purpose of this study was to evaluate the clinical outcomes after arthroscopic management of irreducible posterolateral knee dislocation. Twenty-one patients with irreducible posterolateral knee dislocation were treated in our institution from January 2009 to May 2014. Inclusion criteria were as follows: (1) patients who underwent one-stage arthroscopic reduction combined with multiligament reconstruction or repair and (2) patients with a minimum 2-year follow-up. Knee stability was assessed using physical examination and side-to-side differences (SSD) determined with a KT-1000 arthrometer and Telos stress device...
November 2018: Journal of Knee Surgery
Niv Marom, Robert G Marx
A thorough and comprehensive evaluation of failed multiligament knee reconstructions is a key component for optimal outcomes of revision cases. Addressing all associated injuries during surgery, either staged or not, will potentially guarantee better subjective and objective scores. Older age and high-energy mechanism of injury are associated with worse functional outcomes.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jarret M Woodmass, Thomas L Sanders, Nick R Johnson, Isabella T Wu, Aaron J Krych, Michael J Stuart, Bruce A Levy
Injury to the posterolateral corner (PLC) of the knee can lead to both varus and rotational instability. Multiple PLC reconstruction techniques have been described, including one-tailed graft (fibula-based constructs) or two-tailed graft (combined fibula- and tibia-based constructs). The purpose of our study was to evaluate the clinical outcomes of anatomical two-tailed graft reconstruction of the PLC in the setting of multiligament knee injuries (MKLIs) with grade III varus instability. Patients were identified through a prospective MLKI database between 2004 and 2013...
November 2018: Journal of Knee Surgery
George F Rick Hatch, Diego Villacis, Dhanur Damodar, Michael Dacey, Anthony Yi
We aimed to determine factors that affect the quality of life of patients undergoing a standardized surgical and postoperative management protocol for knee dislocations. A total of 31 patients (33 knees) were included in this study. We contacted patients at a minimum of 12 months postoperatively (mean: 38 months; range, 12-111 months) and administered the previously validated Multiligament Quality of Life questionnaire (ML-QOL), 2000 International Knee Documentation Committee Subjective Knee Form (IKDC), and Lysholm Knee Scoring Scale...
November 2018: Journal of Knee Surgery
Joshua S Everhart, Amy Du, Radhika Chalasani, James C Kirven, Robert A Magnussen, David C Flanigan
PURPOSE: To systematically review multiligament knee injury (MLKI) outcome studies to determine overall rates of return to work or sport after MLKI and risk factors for lack of return to work or sport after MLKI. METHODS: A search was performed of MLKI outcome studies from 1950 to March 1, 2017. Ninety-two studies were identified. All included reported return to work, return to sport, or Tegner activity scores. Rates of return to work or sport were determined for overall population and by obesity status, injury severity, and presence of peroneal nerve or vascular injury...
May 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ian J Barrett, Aaron J Krych, Ayoosh Pareek, Nicholas R Johnson, Diane L Dahm, Michael J Stuart, Bruce A Levy
PURPOSE: Multiple techniques have been described in the literature for reconstruction of the medial collateral ligament. The purpose of this study is to describe functional outcome, range of motion, and knee stability following anatomic MCL reconstruction utilizing an Achilles tendon bone allograft after multiligament knee injury. METHODS: A comprehensive search of a single-hospital multiligament knee injury (MLKI) procedural database was conducted to identify all patients that underwent reconstruction of the MCL utilizing an Achilles tendon bone allograft and with 2-year clinical follow-up...
October 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Yasushi Oshima, Norishige Iizawa, Shinro Takai
BACKGROUND: Treatment of multiligament knee injuries, especially in adolescent patients, is challenging for orthopedic surgeons. Repair of collateral ligaments and reconstruction of cruciate ligaments are usually performed, however, ligament reconstruction with transphyseal or physeal-sparing techniques may lead to physeal damage and growth disturbances in skeletally immature patients. We present a case report on performing bicruciate ligament sutures arthroscopically in an adolescent patient...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Jarret M Woodmass, Michael P O'Malley, Aaron J Krych, Patrick J Reardon, Nick R Johnson, Michael J Stuart, Bruce A Levy
PURPOSE: To (1) assess clinical outcomes of revision multiligament knee injury (MLKI) reconstruction at a minimum of 2 years' follow-up and (2) present a standardized treatment algorithm used in treating revision MLKI patients. METHODS: A retrospective review of our institution's MLKI database was performed to identify all patients who underwent revision MLKI reconstructions (≥2 ligaments reconstructed) after implementation of a standardized treatment algorithm in 2000 and had a minimum of 2 years' follow-up...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Chase S Dean, Olivia Fernandes, Mark E Cinque, Jorge Chahla, Robert F LaPrade
We describe the diagnosis, treatment, rehabilitation, and complications of a 27-year-old male paraskiier who sustained a closed high-velocity knee dislocation after colliding with a tree at a speed of 45 mph and falling 40 feet to the ground. Extensive surgery to repair and reconstruct the knee included open lateral capsular repair, open anatomical posterolateral corner reconstruction with split Achilles tendon allograft, open iliotibial band reconstruction with Achilles tendon allograft, arthroscopic anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft, and double-bundle posterior cruciate ligament reconstruction with Achilles tendon allograft for the anterolateral bundle and tibialis anterior tendon allograft for the posteromedial bundle...
September 2017: American Journal of Orthopedics
Jack Porrino, Michael L Richardson, Keegan Hovis, Bruce Twaddle, Albert Gee
BACKGROUND: We identified common morphologies of tibial plateau fractures that arise with multiligament knee injuries (MLKIs), and investigated the relationship of the fracture with ligament tears. We also evaluated the correlation of 3 tibial plateau fracture classification systems (Schatzker, AO, and Duparc). METHODS: Over a 2-year period, a single orthopaedic surgeon at our institution managed 90 MLKIs. Images of those knees with a tibial plateau fracture were retrospectively reviewed and classified per Schatzker, AO, and Duparc systems...
September 12, 2017: Current Problems in Diagnostic Radiology
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