Short-Term Outcome of Multi-Ligament Knee Injury among Sudanese Patients.

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Abstract

11. Knee Surg Sports Traumatol Arthrosc. 2018 Sep;26(9):2865-2871. doi: 10.1007/s00167-017-4784-3. Epub 2017 Nov 29. Poly-traumatic multi-ligament knee injuries: is the knee the limiting factor? Woodmass JM(1), Johnson NR(1), Mohan R(1), Krych AJ(1), Levy BA(2), Stuart MJ(1). Author information: (1)Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. (2)Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Levy.bruce@mayo.edu. PURPOSE: Multi-ligament knee injuries (MLKI) from a high-velocity accident are rare but potentially devastating. This matched cohort analysis compares knee functional outcomes after multiple ligament reconstruction in poly-trauma patients to those that occurred in isolation. METHODS: Sixty-two patients with MLKI that occurred either as a component of polytrauma or had occurred in isolation were matched according to age, sex, and knee dislocation grade. Functional outcomes and knee physical examination were assessed at a 2-year follow-up. New Injury Severity Score (NISS) was calculated based on the poly-traumatic injury pattern. Risk factors for worse outcomes in the poly-trauma cohort were analyzed. RESULTS: The mean IKDC, Lysholm, and NISS scores in the polytrauma cohort were 57.2 ± 21.9, 62 ± 22, and 40.9 ± 20.4, respectively, at a mean of 67 months (range 24-220). The isolated knee injury group was followed for a mean of 74 months (range 24-266) with mean IKDC and Lysholm scores of 71.1 ± 26.5 and 78 ± 23, respectively. Patients in the control cohort had significantly higher IKDC (p = 0.01) and Lysholm scores, (p = 0.003). There were no major differences between the two groups in regards physical examination findings at final follow-up. None of the analyzed risk factors was predictive of poor outcome. CONCLUSION: When comparing knees with similar multi-ligament and neurovascular injury patterns, patients who sustained their injury as a result of poly-trauma demonstrated significantly lower functional scores following reconstruction. This is despite restoration of similar knee stability and range of motion. The functional outcomes following MLKI reconstruction in poly-traumatized patients are influenced by factors other than the knee including concomitant injuries and psychosocial factors. LEVEL OF EVIDENCE: Therapeutic Level III. DOI: 10.1007/s00167-017-4784-3