Subscribe to RSS
DOI: 10.1055/a-1884-0240
S2e-Leitlinie „Kniegelenkluxation“
Article in several languages: deutsch | EnglishZusammenfassung
Bei einer Knieluxation handelt es sich um eine besonders schwere Form der Multiligamentverletzung. Aufgrund der häufig hohen Verletzungskomplexität existiert eine Vielfalt unterschiedlicher Diagnostik- und Versorgungsstrategien. Mit dem Ziel evidenzbasierter Therapieempfehlungen richtet sich die S2e-Leitlinie „Knieluxation“ an alle an der Diagnostik und Therapie beteiligten Berufsgruppen (Orthopäden und Unfallchirurgen, Physiotherapeuten, ambulante/stationäre Operateure, Sportmediziner etc.) sowie Betroffene (Patient*innen mit Knieluxation) und Leistungserbringer (Krankenkassen, Rentenversicherungsträger). Diese umfasst neben der Darlegung konzeptioneller Unterschiede zwischen den Verletzungsentitäten die Besonderheiten der Diagnostik, konservativen und operativen Therapieoptionen auch Aspekte der Nachbehandlung vor dem Hintergrund des interdisziplinären Behandlungsansatzes einer schweren Knieverletzung.
Schlüsselwörter
Kniegelenkluxation - vorderes Kreuzband - hinteres Kreuzband - Gefäßverletzung - NervenverletzungPublication History
Received: 24 March 2022
Accepted after revision: 22 June 2022
Article published online:
05 September 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Twaddle BC, Bidwell TA, Chapman JR. Knee dislocations: where are the lesions? A prospective evaluation of surgical findings in 63 cases. J Orthop Trauma 2003; 17: 198-202
- 2 Lachman JR, Rehman S, Pipitone PS. Traumatic Knee Dislocations: Evaluation, Management, and Surgical Treatment. Orthop Clin North Am 2015; 46: 479-493
- 3 Chhabra A, Cha PS, Rihn JA. et al. Surgical management of knee dislocations. Surgical technique. J Bone Joint Surg Am 2005; 87 (Suppl. 01) S1-S21
- 4 Schenck RJ. Classification of knee dislocation. Oper Tech Sports Med 2003; 11: 193-198
- 5 Kennedy JC. Complete Dislocation of the Knee Joint. J Bone Joint Surg Am 1963; 45: 889-904
- 6 Brautigan B, Johnson DL. The epidemiology of knee dislocations. Clin Sports Med 2000; 19: 387-397
- 7 Natsuhara KM, Yeranosian MG, Cohen JR. et al. What is the frequency of vascular injury after knee dislocation?. Clin Orthop Relat Res 2014; 472: 2615-2620
- 8 Moatshe G, Dornan GJ, Loken S. et al. Demographics and Injuries Associated With Knee Dislocation: A Prospective Review of 303 Patients. Orthop J Sports Med 2017; 5: 2325967117706521
- 9 Maslaris A, Brinkmann O, Bungartz M. et al. Management of knee dislocation prior to ligament reconstruction: What is the current evidence? Update of a universal treatment algorithm. Eur J Orthop Surg Traumatol 2018; 28: 1001-1015
- 10 Woodmass JM, Romatowski NP, Esposito JG. et al. A systematic review of peroneal nerve palsy and recovery following traumatic knee dislocation. Knee Surg Sports Traumatol Arthrosc 2015; 23: 2992-3002
- 11 Werner BC, Gwathmey FW jr., Higgins ST. et al. Ultra-low velocity knee dislocations: patient characteristics, complications, and outcomes. Am J Sports Med 2014; 42: 358-363
- 12 Peek RD, Haynes DW. Compartment syndrome as a complication of arthroscopy. A case report and a study of interstitial pressures. Am J Sports Med 1984; 12: 464-468
- 13 Plancher KD, Siliski J. Long-term functional results and complications in patients with knee dislocations. J Knee Surg 2008; 21: 261-268
- 14 Giannoudis PV, Roberts CS, Parikh AR. et al. Knee dislocation with ipsilateral femoral shaft fracture: a report of five cases. J Orthop Trauma 2005; 19: 205-210
- 15 Azar FM, Brandt JC, Miller 3rd RH. et al. Ultra-low-velocity knee dislocations. Am J Sports Med 2011; 39: 2170-2174
- 16 Meyers MH, Moore TM, Harvey jr JP. Traumatic dislocation of the knee joint. J Bone Joint Surg Am 1975; 57: 430-433
- 17 Sisto DJ, Warren RF. Complete knee dislocation. A follow-up study of operative treatment. Clin Orthop Relat Res 1985; (198) 94-101
- 18 Darcy G, Edwards E, Hau R. Epidemiology and outcomes of traumatic knee dislocations: Isolated vs multi-trauma injuries. Injury 2018; 49: 1183-1187
- 19 Harner CD, Waltrip RL, Bennett CH. et al. Surgical management of knee dislocations. J Bone Joint Surg Am 2004; 86: 262-273
- 20 Wascher DC, Dvirnak PC, DeCoster TA. Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma 1997; 11: 525-529
- 21 Liow RY, McNicholas MJ, Keating JF. et al. Ligament repair and reconstruction in traumatic dislocation of the knee. J Bone Joint Surg Br 2003; 85: 845-851
- 22 McCoy GF, Hannon DG, Barr RJ. et al. Vascular injury associated with low-velocity dislocations of the knee. J Bone Joint Surg Br 1987; 69: 285-287
- 23 Shelbourne KD, Klootwyk TE. Low-velocity knee dislocation with sports injuries. Treatment principles. Clin Sports Med 2000; 19: 443-456
- 24 Shelbourne KD, Porter DA, Clingman JA. et al. Low-velocity knee dislocation. Orthop Rev 1991; 20: 995-1004
- 25 Vaidya R, Roth M, Nanavati D. et al. Low-Velocity Knee Dislocations in Obese and Morbidly Obese Patients. Orthop J Sports Med 2015; 3: 2325967115575719
- 26 Georgiadis AG, Guthrie ST, Shepard AD. Beware of ultra-low-velocity knee dislocation. Orthopedics 2014; 37: 656-658
- 27 Frosch KH, Preiss A, Heider S. et al. Primary ligament sutures as a treatment option of knee dislocations: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2013; 21: 1502-1509
- 28 Xu B, Xu H, Tu J. et al. Initial Assessment and Implications for Surgery: The Missed Diagnosis of Irreducible Knee Dislocation. J Knee Surg 2018; 31: 254-263
- 29 Medina O, Arom GA, Yeranosian MG. et al. Vascular and nerve injury after knee dislocation: a systematic review. Clin Orthop Relat Res 2014; 472: 2621-2629
- 30 Darabos N, Gusic N, Vlahovic T. et al. Staged management of knee dislocation in polytrauma injured patients. Injury 2013; 44 (Suppl. 03) S40-S45
- 31 D’Alleyrand JC, O’Toole RV. The evolution of damage control orthopedics: current evidence and practical applications of early appropriate care. Orthop Clin North Am 2013; 44: 499-507
- 32 Bouillon B, Rixen D, Maegele M. et al. Damage Control Orthopedics. What is the current situation?. Unfallchirurg 2009; 112: 860-869
- 33 Howells NR, Brunton LR, Robinson J. et al. Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury 2011; 42: 1198-1204
- 34 Barnes CJ, Pietrobon R, Higgins LD. Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta-analysis. J Trauma 2002; 53: 1109-1114
- 35 Fortuna G, DuBose JJ, Mendelsberg R. et al. Contemporary outcomes of lower extremity vascular repairs extending below the knee: A multicenter retrospective study. J Trauma Acute Care Surg 2016; 81: 63-70
- 36 Mills WJ, Barei DP, McNair P. The value of the ankle-brachial index for diagnosing arterial injury after knee dislocation: a prospective study. J Trauma 2004; 56: 1261-1265
- 37 King 3rd JJ, Cerynik DL, Blair JA. et al. Surgical outcomes after traumatic open knee dislocation. Knee Surg Sports Traumatol Arthrosc 2009; 17: 1027-1032
- 38 Kannus P, Jarvinen M. Nonoperative treatment of acute knee ligament injuries. A review with special reference to indications and methods. Sports Med 1990; 9: 244-260
- 39 Dedmond BT, Almekinders LC. Operative versus nonoperative treatment of knee dislocations: a meta-analysis. Am J Knee Surg 2001; 14: 33-38
- 40 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
- 41 Montgomery TJ, Savoie FH, White JL. et al. Orthopedic management of knee dislocations. Comparison of surgical reconstruction and immobilization. Am J Knee Surg 1995; 8: 97-103
- 42 O’Malley MP, Pareek A, Reardon P. et al. Treatment of Peroneal Nerve Injuries in the Multiligament Injured/Dislocated Knee. J Knee Surg 2016; 29: 287-292
- 43 Bonnevialle P, Dubrana F, Galau B. et al. Common peroneal nerve palsy complicating knee dislocation and bicruciate ligaments tears. Orthop Traumatol Surg Res 2010; 96: 64-69
- 44 Fanelli GC, Giannotti BF, Edson CJ. Arthroscopically assisted combined posterior cruciate ligament/posterior lateral complex reconstruction. Arthroscopy 1996; 12: 521-530
- 45 Smyth MP, Koh JL. A review of surgical and nonsurgical outcomes of medial knee injuries. Sports Med Arthrosc Rev 2015; 23: e15-e22
- 46 Hegyes MS, Richardson MW, Miller MD. Knee dislocation. Complications of nonoperative and operative management. Clin Sports Med 2000; 19: 519-543
- 47 Schenck jr RC. , Richter DL, Wascher DC. Knee Dislocations: Lessons Learned From 20-Year Follow-up. Orthop J Sports Med 2014; 2: 2325967114534387
- 48 Freychet B, Kennedy NI, Sanders TL. et al. No difference between single and staged posterolateral corner surgical procedures in the multiligament injured/dislocated knee. Knee Surg Sports Traumatol Arthrosc 2020; 28: 2170-2176
- 49 Heitmann M, Akoto R, Krause M. et al. Management of acute knee dislocations: anatomic repair and ligament bracing as a new treatment option-results of a multicentre study. Knee Surg Sports Traumatol Arthrosc 2019; 27: 2710-2718
- 50 Otto A, Helal A, Imhoff FB. et al. Promising clinical and magnetic resonance imaging results after internal bracing of acute posterior cruciate ligament lesions in multiple injured knees. Knee Surg Sports Traumatol Arthrosc 2020; 28: 2543-2550
- 51 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
- 52 Kovachevich R, Shah JP, Arens AM. et al. Operative management of the medial collateral ligament in the multi-ligament injured knee: an evidence-based systematic review. Knee Surg Sports Traumatol Arthrosc 2009; 17: 823-829
- 53 Barrett IJ, Krych AJ, Pareek A. et al. Short- to mid-term outcomes of anatomic MCL reconstruction with Achilles tendon allograft after multiligament knee injury. Knee Surg Sports Traumatol Arthrosc 2018; 26: 2952-2959
- 54 Stannard JP, Brown SL, Farris RC. et al. The posterolateral corner of the knee: repair versus reconstruction. Am J Sports Med 2005; 33: 881-888
- 55 LaPrade RF, Johansen S, Agel J. et al. Outcomes of an anatomic posterolateral knee reconstruction. J Bone Joint Surg Am 2010; 92: 16-22
- 56 Arciero RA. Anatomic posterolateral corner knee reconstruction. Arthroscopy 2005; 21: 1147
- 57 Miyatake S, Kondo E, Tsai TY. et al. Biomechanical comparisons between 4-strand and modified Larson 2-strand procedures for reconstruction of the posterolateral corner of the knee. Am J Sports Med 2011; 39: 1462-1469
- 58 Domnick C, Frosch KH, Raschke MJ. et al. Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State: A Human Cadaveric Study. Arthroscopy 2017; 33: 1821-1830.e1
- 59 Feldman V, Biadsi A, Slavin O. et al. Pulmonary Embolism After Application of a Sterile Elastic Exsanguination Tourniquet. Orthopedics 2015; 38: e1160-e1163
- 60 Raschke MJ, Kittl C, Domnick C. Partial proximal tibia fractures. EFORT Open Rev 2017; 2: 241-249
- 61 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
- 62 Mook WR, Miller MD, Diduch DR. et al. Multiple-ligament knee injuries: a systematic review of the timing of operative intervention and postoperative rehabilitation. J Bone Joint Surg Am 2009; 91: 2946-2957
- 63 Lynch AD, Chmielewski T, Bailey L. et al. Current Concepts and Controversies in Rehabilitation After Surgery for Multiple Ligament Knee Injury. Curr Rev Musculoskelet Med 2017; 10: 328-345
- 64 Richter DL, Bankhead CP, Wascher DC. et al. Knee Dislocation (KD) IV Injuries of the Knee: Presentation, Treatment, and Outcomes. Clin Sports Med 2019; 38: 247-260
- 65 Scarcella NR, Weinberg DS, Bowen S. et al. Clinical and Functional Results of 119 Patients With Knee Dislocations. J Orthop Trauma 2017; 31: 380-386
- 66 Savarese E, Bisicchia S, Romeo R. et al. Role of high tibial osteotomy in chronic injuries of posterior cruciate ligament and posterolateral corner. J Orthop Traumatol 2011; 12: 1-17
- 67 Stannard JP, Nuelle CW, McGwin G. et al. Hinged external fixation in the treatment of knee dislocations: a prospective randomized study. J Bone Joint Surg Am 2014; 96: 184-191
- 68 Mariani PP, Santoriello P, Iannone S. et al. Comparison of surgical treatments for knee dislocation. Am J Knee Surg 1999; 12: 214-221
- 69 Levy BA, Stuart MJ. Treatment of PCL, ACL, and lateral-side knee injuries: acute and chronic. J Knee Surg 2012; 25: 295-305
- 70 Dwyer T, Marx RG, Whelan D. Outcomes of treatment of multiple ligament knee injuries. J Knee Surg 2012; 25: 317-326
- 71 Johnson ME, Foster L, DeLee JC. Neurologic and vascular injuries associated with knee ligament injuries. Am J Sports Med 2008; 36: 2448-2462
- 72 Tomaino M, Day C, Papageorgiou C. et al. Peroneal nerve palsy following knee dislocation: pathoanatomy and implications for treatment. Knee Surg Sports Traumatol Arthrosc 2000; 8: 163-165
- 73 Welling RE, Kakkasseril J, Cranley JJ. Complete dislocations of the knee with popliteal vascular injury. J Trauma 1981; 21: 450-453