Moreno Bernardo, Vaz Pedro, Melo Bruna, Cunha Mafalda, Vaz Rui
Physical Medicine and Rehabilitation, Hospital Senhora da Oliveira - Guimarães, Guimarães, PRT.
Orthopaedics and Traumatology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PRT.
Cureus. 2022 Jan 25;14(1):e21607. doi: 10.7759/cureus.21607. eCollection 2022 Jan.
Traumatic knee dislocations are serious and complex injuries, defined as clinical and/or radiological loss of tibiofemoral congruence, which may represent real emergencies to the integrity of the affected limb. This lesion is responsible for multi-ligament tears but the most serious possible complications are related to vascular and peripheral nerve injuries. Recent studies show that surgical treatment has better functional results and higher return rates to sports practice compared to conservative treatment. However, there is still no consensus on the ideal surgical technique and the timing of surgery. After conservative management or surgical treatment, rehabilitation treatment plays a key role in the recovery process. There are few studies evaluating the return to competition after traumatic knee dislocation and those athletes who return have difficulty reaching the pre-injury level. Here, we report the case of a professional football player who suffered a traumatic knee dislocation, with multiple ligament tears associated with vascular and neurological damage. Three hours after the initial lesion a double interposition bypass was done with the great saphenous vein, returning flow distally. It was decided not to perform ligament surgery. Two years after a long and intense rehabilitation program the athlete successfully returned to competition.
创伤性膝关节脱位是严重且复杂的损伤，定义为胫股关节面失去临床和/或影像学上的对合关系，这可能对患肢的完整性构成真正的紧急情况。这种损伤会导致多条韧带撕裂，但最严重的潜在并发症与血管和周围神经损伤有关。最近的研究表明，与保守治疗相比，手术治疗具有更好的功能结果和更高的恢复运动的比率。然而，对于理想的手术技术和手术时机仍未达成共识。在保守治疗或手术治疗后，康复治疗在恢复过程中起着关键作用。评估创伤性膝关节脱位后恢复比赛情况的研究很少，而且那些恢复的运动员很难达到受伤前的水平。在此，我们报告一例职业足球运动员创伤性膝关节脱位的病例，伴有多条韧带撕裂，并伴有血管和神经损伤。初始损伤3小时后，采用大隐静脉进行双置管搭桥术，恢复远端血流。决定不进行韧带手术。经过长期强化康复计划两年后，该运动员成功重返赛场。
