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. 2022 Aug 1;36(8):394-399.
doi: 10.1097/BOT.0000000000002348.

Long-Term Outcomes of Multiligament Knee Injuries

Affiliations

Long-Term Outcomes of Multiligament Knee Injuries

Tina Zhang et al. J Orthop Trauma. .

Abstract

Objective: To characterize long-term outcomes of multiligament knee injuries (MLKIs) using patient-reported outcome measures, physical examination, and knee radiographs.

Design: Retrospective clinical follow-up.

Methods: Twenty knees (18 patients) were evaluated at a mean follow-up of 13.1 years (range 11-15 years). The primary outcome measure was the Internal Knee Documentation Committee score. Patients also completed secondary patient-based outcome assessments including Patient-Reported Outcomes Measurement Information System computer adaptive testing, Short Form-36, and Tegner activity score. Sixteen knees (14 patients) also had physical examination and bilateral knee radiographs assessed with the Kellgren-Lawrence score.

Results: The mean Internal Knee Documentation Committee score was 56 points, which was significantly lower than the age-matched normative value of 77 ( P = 0.004) and exceeds the minimum clinically important difference of 12 points. Most secondary outcome scores were worse than normative population values. Posttraumatic arthritis was present in 100% of MLKIs that had radiographs. Comparing operative versus nonoperative management, there were no statistical differences in patient demographics, injury characteristics, physical examination, or imaging, but surgical patients had better Short Form-36 Social Functioning (89 vs. 63, P = 0.02) and Tegner scores (4.5 vs. 2.9, P = 0.05).

Conclusion: The long-term outcomes of MLKIs are generally poor, and posttraumatic radiographic evidence of arthritis seems to be universal . Operative management of these injuries may improve long-term outcomes. Clinicians should be aware of these results when counseling patients.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

The authors report no conflict of interest.

References

    1. Ríos A, Villa A, Fahandezh H, et al. Results after treatment of traumatic knee dislocations: a report of 26 cases. J Trauma. 2003;55:489–494.
    1. Wong CH, Tan JL, Chang HC, et al. Knee dislocations-a retrospective study comparing operative versus closed immobilization treatment outcomes. Knee Surg Sports Traumatol Arthrosc. 2004;12:540–544.
    1. Richter M, Bosch U, Wippermann B, et al. Comparison of surgical repair or reconstruction of the cruciate ligaments versus nonsurgical treatment in patients with traumatic knee dislocations. Am J Sports Med. 2002;30:718–727.
    1. Levy BA, Dajani KA, Whelan DB, et al. Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy. 2009;25:430–438.
    1. Moatshe G, Dornan GJ, Ludvigsen T, et al. High prevalence of knee osteoarthritis at a minimum 10-year follow-up after knee dislocation surgery. Knee Surg Sports Traumatol Arthrosc. 2017;25:3914–3922.

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