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- Title
External fixator for treatment of the sub-acute and chronic multi-ligament-injured knee.
- Authors
Angelini, Fabio; Helito, Camilo; Bonadio, Marcelo; Guimarães, Tales; Barreto, Ronald; Pécora, José; Camanho, Gilberto; Mota e Albuquerque, Roberto; Angelini, Fabio Janson; Helito, Camilo Partezani; Bonadio, Marcelo Batista; Guimarães, Tales Molica; Barreto, Ronald Bispo; Pécora, José Ricardo; Camanho, Gilberto Luis; da Mota E Albuquerque, Roberto Freire
- Abstract
<bold>Purpose: </bold>To assess whether the use of an articulated external fixator provides improvements in the mobility, stability and subjective function of patients undergoing ligament reconstruction.<bold>Methods: </bold>Thirty-three patients with sub-acute and chronic knee dislocation were subjected to multi-ligament reconstruction surgery. These patients were randomly allocated to two groups for immobilization after reconstruction: group 0-control (18 patients), with rigid knee bracing, and group 1-articulated external fixator (15 patients). The stability of the reconstructed ligaments was assessed after at least 14 months (26.6-month average) postoperatively by physical examination. Deficit of extension and flexion was measured in relation to the unaffected contralateral knee, and the Lysholm knee scoring scale questionnaire was applied.<bold>Results: </bold>There was no difference in the assessment of joint stability between the groups. In group 1, patients showed less flexion deficit (4.8° ± 5.4° vs. 18.2° ± 14.8°, p < 0.05), and the percentage of patients with a flexion deficit of 5° or less were higher compared with group 0 (64 vs. 18 %, p < 0.05). There was no difference between groups in relation to extension loss. Group 1 also presented better Lysholm scores, with 73 % of patients rated as excellent or good compared with 35 % in group 0 (p < 0.05).<bold>Conclusions: </bold>Compared with the control rehabilitation protocol with rigid knee bracing in extension, the use of an articulated external fixator in the treatment of chronic multi-ligament-injured knees provided the same ligament stability, better final range of motion and improved Lysholm score. Patients presenting with chronic multi-ligament instability should be considered for articulated external fixation to supplement reconstruction procedures.<bold>Level Of Evidence: </bold>Randomized controlled trial, Level I.
- Subjects
ORTHOPEDIC surgery; ARTICULAR ligament surgery; ARTICULAR ligament injuries; CHRONIC diseases; COMPARATIVE studies; EXTERNAL fixators; RANGE of motion of joints; KNEE injuries; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; PLASTIC surgery; EVALUATION research; RANDOMIZED controlled trials; ACUTE diseases; KNEE dislocation; DISEASE complications; EQUIPMENT &; supplies
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2015, Vol 23, Issue 10, p3012
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-015-3719-0