Surgically treated acute knee dislocations with knee stiffness perform equally as well as non-stiff knees when treated with arthroscopic arthrolysis

IF 1.6 4区医学 Q3 ORTHOPEDICS Knee Pub Date : 2024-09-05 DOI:10.1016/j.knee.2024.08.017

Hendrik Fahlbusch, Markus Neumann, Jannik Frings, Karl-Heinz Frosch, Matthias Krause

{"title":"Surgically treated acute knee dislocations with knee stiffness perform equally as well as non-stiff knees when treated with arthroscopic arthrolysis","authors":"Hendrik Fahlbusch, Markus Neumann, Jannik Frings, Karl-Heinz Frosch, Matthias Krause","doi":"10.1016/j.knee.2024.08.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>Postoperative knee stiffness is a common issue in multiligament knee injuries (MLKIs). This study aims to compare outcomes between MLKI patients who underwent postoperative arthroscopic lysis of arthrofibrosis (LOA) for limited range of motion (ROM) and those who did not.</p></div><div><h3>Methods</h3><p>Thirty-one patients (10 IIIM, nine IIIL and 12 IV) were included in this retrospective clinical study with acute type III or IV knee dislocations, while two patients were lost to follow up. Thirteen patients underwent LOA at a mean of 18.7 ± 8.4 weeks (Group A), while 18 did not require this intervention (Group B). Patient-reported outcome measures (IKDC, Lysholm, VAS) and ROM were evaluated.</p></div><div><h3>Results</h3><p>The average follow up period was 31.0 ± 10.2 months. The mean time to LOA was 19.4 ± 7.6 weeks and a significant increase in ROM was observed after LOA (flexion: before LOA: 83.8° ± 19.2, after LOA: 119.6° ± 9.9; <em>P</em> < 0.0001). There were no significant differences between groups regarding clinical scores (Lysholm: Group A 85.0 ± 13.4, Group B 84.6 ± 14.5; IKDC: Group A 74.3 ± 10.8, Group B 76.7 ± 14.7) and ROM (flexion: Group A 118.6° ± 9.8, Group B 124.3° ± 12.8). There were no complications regarding LOA.</p></div><div><h3>Conclusions</h3><p>Patients, whether undergoing LOA or not, performed equally well in terms of ROM and clinical scores at final follow up, while timing of LOA appears less critical. LOA is a simple, durable and safe method of treating ROM deficits in patients treated for acute knee dislocation, with very good results.</p></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 114-119"},"PeriodicalIF":1.6000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0968016024001510/pdfft?md5=e8d1eb89f0c9025204123d34579153ca&pid=1-s2.0-S0968016024001510-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0968016024001510","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Postoperative knee stiffness is a common issue in multiligament knee injuries (MLKIs). This study aims to compare outcomes between MLKI patients who underwent postoperative arthroscopic lysis of arthrofibrosis (LOA) for limited range of motion (ROM) and those who did not.

Methods

Thirty-one patients (10 IIIM, nine IIIL and 12 IV) were included in this retrospective clinical study with acute type III or IV knee dislocations, while two patients were lost to follow up. Thirteen patients underwent LOA at a mean of 18.7 ± 8.4 weeks (Group A), while 18 did not require this intervention (Group B). Patient-reported outcome measures (IKDC, Lysholm, VAS) and ROM were evaluated.

Results

The average follow up period was 31.0 ± 10.2 months. The mean time to LOA was 19.4 ± 7.6 weeks and a significant increase in ROM was observed after LOA (flexion: before LOA: 83.8° ± 19.2, after LOA: 119.6° ± 9.9; P < 0.0001). There were no significant differences between groups regarding clinical scores (Lysholm: Group A 85.0 ± 13.4, Group B 84.6 ± 14.5; IKDC: Group A 74.3 ± 10.8, Group B 76.7 ± 14.7) and ROM (flexion: Group A 118.6° ± 9.8, Group B 124.3° ± 12.8). There were no complications regarding LOA.

Conclusions

Patients, whether undergoing LOA or not, performed equally well in terms of ROM and clinical scores at final follow up, while timing of LOA appears less critical. LOA is a simple, durable and safe method of treating ROM deficits in patients treated for acute knee dislocation, with very good results.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

经手术治疗的急性膝关节脱位伴有膝关节僵硬者，在接受关节镜关节切除术治疗时，其表现与非僵硬膝关节相同。

目的：术后膝关节僵硬是多韧带膝关节损伤（MLKI）的常见问题。本研究旨在比较因活动范围（ROM）受限而在术后接受关节镜下关节纤维化溶解术（LOA）的膝关节多韧带损伤（MLKI）患者与未接受该手术的患者的治疗效果：这项回顾性临床研究共纳入了31例急性III型或IV型膝关节脱位患者（10例IIIM、9例IIIL和12例IV型），其中2例患者失去了随访机会。13名患者接受了LOA治疗，平均时间为18.7周±8.4周（A组），18名患者无需接受该治疗（B组）。对患者报告的结果指标（IKDC、Lysholm、VAS）和ROM进行了评估：平均随访时间为（31.0 ± 10.2）个月。结果：平均随访时间为（31.0±10.2）个月，LOA的平均时间为（19.4±7.6）周，LOA后观察到ROM显著增加（屈曲：LOA前：83.8°±19.2，LOA后：119.6°±9.9；P 结论：LOA的平均时间为（19.4±7.6）周：无论患者是否接受了LOA，他们在最终随访时的ROM和临床评分方面表现同样出色，而LOA的时机似乎并不那么重要。LOA是治疗急性膝关节脱位患者ROM缺损的一种简单、持久和安全的方法，效果非常好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.