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- Title
Are meniscal tears and articular cartilage injury predictive of inferior patient outcome after surgical reconstruction for the dislocated knee?
- Authors
King, Alexander; Krych, Aaron; Prince, Matthew; Sousa, Paul; Stuart, Michael; Levy, Bruce; King, Alexander H; Krych, Aaron J; Prince, Matthew R; Sousa, Paul L; Stuart, Michael J; Levy, Bruce A
- Abstract
<bold>Purpose: </bold>A paucity of data exists on the effects of articular cartilage and meniscal injury in the setting of knee dislocations. The purpose of this study is to determine whether concomitant intra-articular injuries at the time of multiligament reconstruction for knee dislocation are associated with inferior outcomes.<bold>Methods: </bold>The records of patients who underwent surgical treatment for multiligament knee injury between 1992 and 2012 were retrospectively reviewed. Patients included had a PCL-based multiligament knee injury or a minimum of three disrupted ligaments, both indicative of knee dislocation. A logistic regression model was used to determine whether articular cartilage injuries (grade 2 involving ≥50 % of the condylar width or greater, or any grade III/IV lesions) and meniscus tears are predictors of IKDC outcome scores collected at a minimum of 2 years postoperatively.<bold>Results: </bold>Of the 121 patients who met inclusion criteria, 2-year minimum follow-up was available on 95 patients (79 %). The cohort was 77 % male and had a median age of 32 years (16-62) at the time of surgery and was followed for an average of 6 years. Articular cartilage injury was present in 40 % of knees: medial femoral condyle (20 %); medial tibial plateau (9 %); lateral femoral condyle (5 %); lateral tibial plateau (4 %); patella (18 %); trochlear (5 %). Meniscal injury was present in 56 % of patients (isolated medial, 22 %; isolated lateral, 22 %; combined, 12 %). IKDC scores were significantly lower for patients with any cartilage damage (p = 0.03), combined medial and lateral meniscus tears (p = 0.02), medial-sided articular cartilage damage (p = 0.03), medial femoral condyle (p = 0.04) and trochlear (p = 0.03) lesions.<bold>Conclusion: </bold>Articular cartilage damage and meniscus tears are frequently associated with a knee dislocation. This study showed IKDC scores were significantly lower for patients with cartilage damage or combined medial and lateral meniscus tears at mid-term follow-up of 6 years.<bold>Level Of Evidence: </bold>IV.
- Subjects
MENISCUS surgery; MENISCUS injuries; ARTICULAR cartilage injuries; ARTICULAR cartilage; KNEE injuries; ORTHOPEDIC surgery; PROGNOSIS; QUESTIONNAIRES; ORGAN rupture; PLASTIC surgery; RETROSPECTIVE studies; KNEE dislocation; DISEASE complications; SURGERY
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2015, Vol 23, Issue 10, p3008
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-015-3671-z