Engebretsen Lars, Risberg May Arna, Robertson Ben, Ludvigsen Tom C, Johansen Steinar
Orthopedic Center, Oslo University Hospital, Ullevaal, Norway.
Knee Surg Sports Traumatol Arthrosc. 2009 Sep;17(9):1013-26. doi: 10.1007/s00167-009-0869-y. Epub 2009 Jul 16.
Dislocation of the knee is a relatively rare injury with modern arthroscopic techniques, operative reconstruction has become the standard of care. The primary aim of this study was to prospectively follow a large, consecutive series of patients with knee dislocation to document associated injuries, surgical treatment, knee function, and knee osteoarthritis (OA) at a minimum of 2 years follow-up. Hundred and twenty-two consecutive patients with a traumatic knee dislocation (Schenck II-IV) were treated at the Oslo University Hospital, Ulleval, between May 1996 and December 2004. Follow-up evaluation of 85 patients consisted of evaluation of knee joint laxity using the KT1000, the Lachman test, the pivot shift test, the reversed pivot shift, the posterior drawer test, the dial test, and the varus-valgus tests compared to the uninjured knee. Knee function was evaluated using the Lysholm score, the Tegner activity level score, the IKDC2000 score, and four single leg hop tests. Radiographic evaluation was performed using the Kellgren & Lawrence classification grade 0-4. Knee function at a minimum of 2 years after surgery disclosed a Lysholm score of a median of 83, a Tegner activity score of 5, and above 83% on all single leg hop tests compared to the uninjured side. Knee function was lower in the patients with a knee dislocation caused by high-energy trauma compared to low energy trauma. Eighty-seven percent had Kellgren & Lawrence grade 2 or higher for the injured knee compared to 35% for the uninjured knee.
膝关节脱位是一种相对罕见的损伤。随着现代关节镜技术的发展,手术重建已成为标准的治疗方法。本研究的主要目的是对一系列连续的大量膝关节脱位患者进行前瞻性随访,以记录相关损伤、手术治疗、膝关节功能以及在至少2年随访期内的膝关节骨关节炎(OA)情况。1996年5月至2004年12月期间,奥斯陆大学医院Ulleval院区共治疗了122例连续的创伤性膝关节脱位(Schenck II-IV型)患者。对85例患者的随访评估包括使用KT1000、Lachman试验、轴移试验、反向轴移试验、后抽屉试验、旋转试验以及内外翻试验评估膝关节松弛度,并与未受伤的膝关节进行比较。使用Lysholm评分、Tegner活动水平评分、IKDC2000评分以及四项单腿跳试验评估膝关节功能。采用Kellgren & Lawrence分级0-4级进行影像学评估。术后至少2年的膝关节功能显示,Lysholm评分中位数为83分,Tegner活动评分为5分,与未受伤侧相比,所有单腿跳试验的得分均高于83%。与低能量创伤导致的膝关节脱位患者相比,高能量创伤导致膝关节脱位的患者膝关节功能更低。受伤膝关节的Kellgren & Lawrence分级为2级或更高的患者占87%,而未受伤膝关节的这一比例为35%。