Owens Brett D, Neault Mark, Benson Emily, Busconi Brian D
Department of Orthopedics, University of Massachusetts Medical School, Worcester, MA, USA.
J Orthop Trauma. 2007 Feb;21(2):92-6. doi: 10.1097/BOT.0b013e3180321318.
To investigate the outcomes of knee dislocations treated with primary repair and an early rehabilitation protocol.
Retrospective.
Level 1 Trauma Center.
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).
All patients underwent primary repair of all injured ligaments using a consistent technique and early rehabilitation protocol.
In addition to range of motion and stability assessment, Lysholm and Tegner scores were used to evaluate outcome.
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.
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.
探讨一期修复及早期康复方案治疗膝关节脱位的疗效。
回顾性研究。
一级创伤中心。
纳入1994年至2002年间由同一位外科医生治疗的连续性膝关节脱位患者,共27例患者30个膝关节脱位。25例患者(28个膝关节)由一名独立观察者进行评估,平均随访时间为48个月(13 - 82个月)。
所有患者均采用一致的技术对所有损伤韧带进行一期修复,并采用早期康复方案。
除活动范围和稳定性评估外,采用Lysholm和Tegner评分评估疗效。
术后Lysholm评分平均为89.0。对22例可供检查的单侧脱位进行活动范围分析,结果显示平均伸直丧失1.9度,平均屈曲丧失10.2度,平均活动弧度为119.3度。总体而言,膝关节在临床上是稳定的。
韧带一期修复联合早期康复计划的疗效与已发表的韧带重建结果相当。对于创伤患者,膝关节脱位时韧带一期修复应被视为一种有效的选择。