Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
Eur J Orthop Surg Traumatol. 2024 Apr;34(3):1349-1356. doi: 10.1007/s00590-023-03807-4. Epub 2023 Dec 26.
To describe our institutional experience and results in the surgical management of multiligament knee injuries (MLKI).
Retrospective series of MLKI consecutively operated on at a single, level I Trauma Center. Data on patients' baseline characteristics, injuries, treatments, and outcomes were recorded up to one-year follow-up. Recorded outcomes included the Tegner-Lysholm Knee Scoring Scale (TLKSS), return to work, and patient satisfaction.
MLKI incidence was 0.03% among 9897 orthopedic trauma admissions. Twenty-four patients of mean age 43.6 years were included in analysis. The mean Injury Severity Score was 12.6. Five patients presented with knee dislocations and six had fracture-dislocations, two of them open fractures. There was one popliteal artery injury requiring a bypass and four common peroneal nerve palsies. Staged ligamental reconstruction was performed in all cases. There were seven postoperative complications. The median TLKSS was 80 and, though patient satisfaction was high, and dissatisfaction was largely restricted to recreational activities (only 58.3% satisfied). Seventeen patients returned to their previous employment.
We found a high aggregation of fracture-dislocations secondary to road traffic accidents. One in four patients experienced complications, particularly stiffness. Complications were more common in cases involving knee dislocation. Most patients had good functional results, but 25% were unable to return to their previous work, which demonstrates the long-lasting sequelae of this injury.
描述我们在多韧带膝关节损伤（MLKI）的手术治疗方面的机构经验和结果。
对一家一级创伤中心连续进行的 MLKI 的回顾性系列研究。记录了患者的基线特征、损伤、治疗和结果，随访时间长达一年。记录的结果包括 Tegner-Lysholm 膝关节评分量表（TLKSS）、重返工作岗位和患者满意度。
在 9897 例骨科创伤患者中，MLKI 的发生率为 0.03%。分析中纳入了 24 名平均年龄为 43.6 岁的患者。平均损伤严重程度评分（ISS）为 12.6。5 例患者出现膝关节脱位，6 例患者出现骨折脱位，其中 2 例为开放性骨折。有 1 例腘动脉损伤需要搭桥，4 例腓总神经麻痹。所有病例均进行了分期韧带重建。有 7 例术后并发症。TLKSS 的中位数为 80，尽管患者满意度高，但不满意主要限于娱乐活动（只有 58.3%满意）。17 名患者重返以前的工作。
我们发现，由于道路交通意外，骨折脱位的聚集程度很高。四分之一的患者出现并发症，特别是僵硬。膝关节脱位的病例并发症更为常见。大多数患者的功能结果良好，但 25%的患者无法重返以前的工作，这表明这种损伤会留下持久的后遗症。
