Primary repair of knee dislocations: results in 25 patients (28 knees) at a mean follow-up of four years

Abstract

OBJECTIVE: To investigate the outcomes of knee dislocations treated with primary repair and an early rehabilitation protocol. DESIGN: Retrospective. SETTINGS: Level 1 Trauma Center. PATIENTS: Consecutive patients with knee dislocation referred to a single surgeon for care between 1994 and 2002 were included, for a total of 27 patients with 30 knee dislocations. Twenty-five patients (28 knees) were evaluated by an independent observer at a mean of 48 months (13-82 months). INTERVENTION: All patients underwent primary repair of all injured ligaments using a consistent technique and early rehabilitation protocol. MAIN OUTCOME MEASUREMENTS: In addition to range of motion and stability assessment, Lysholm and Tegner scores were used to evaluate outcome. RESULTS: The mean post-operative Lysholm score was 89.0. Range of motion analysis for the 22 unilateral dislocations available for examination showed a mean extension loss of 1.9 degrees and mean flexion loss of 10.2 degrees , with a mean arc of motion of 119.3 degrees . Overall, the knees were found to be clinically stable. CONCLUSIONS: Primary repair of ligaments coupled with an early rehabilitation program provides comparable outcomes to published results of ligament reconstruction. Primary repair of ligaments in the dislocated knee should be considered as an effective option in the trauma population.