Abstract
The purpose of this study was to evaluate the clinical outcomes after arthroscopic
management of irreducible posterolateral knee dislocation. Twenty-one patients with
irreducible posterolateral knee dislocation were treated in our institution from January
2009 to May 2014. Inclusion criteria were as follows: (1) patients who underwent one-stage
arthroscopic reduction combined with multiligament reconstruction or repair and (2)
patients with a minimum 2-year follow-up. Knee stability was assessed using physical
examination and side-to-side differences (SSD) determined with a KT-1000 arthrometer
and Telos stress device. Other assessments included the International Knee Documentation
Committee (IKDC) subjective score, Lysholm score, Tegner score, and patient satisfaction
rate. Thirteen of the 21 patients (8 males and 5 females) met our inclusion criteria
and were included in this analysis. The mean age was 37.8 years (range, 27–56 years).
The mean time from injury to surgery was 1.84 days (range, 1–3 days). The mean follow-up
period was 32.6 months (range, 24–46 months). At the final follow-up, with the exception
of one patient who had an abnormal valgus stress test, all patients achieved normal
or nearly normal Lachman test, pivot shift test, posterior drawer test, and varus
and valgus stress tests. The mean SSD of total anterior–posterior translation and
isolated anterior translation determined with a KT-1000 arthrometer were 2.15 ± 1.57 mm
(range, 0–6 mm) and 1.61 ± 0.86 mm (range, 1–4 mm), respectively. The mean SSD of
anterior translation, posterior translation, and medial and lateral joint gapping
determined with a Telos stress device were 2.23 ± 0.92 mm (range, 1–4 mm), 3.23 ± 1.16 mm
(range, 2–5 mm), 1.77 ± 1.87 mm (range, 0–7 mm), and 0.46 ± 0.52 mm (range, 0–2 mm),
respectively. The IKDC subjective score, Lysholm score, and Tegner score improved
significantly postoperatively (p = 0.001) with a satisfaction rate of 84.6%. One-stage arthroscopic reduction combined
with multiligament reconstruction or repair was an effective, reliable treatment for
irreducible posterolateral knee dislocation. This is a case series with level of evidence
as IV.
Keywords knee - dislocation - ligament - reconstruction
