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Beitragstitel Treatment of multiligamentous knee injuries with primary repair and ligament bracing – a viable solution
Beitragscode P35
Autoren
  1. Sophie C. Eberlein Universitätsspital Bern, Inselspital Vortragender
  2. Andreas Hecker Universitätsspital Bern, Inselspital
  3. Florian Schmaranzer Inselspital Bern, Universität Bern
  4. Christoph Huber Universitätsspital Bern, Inselspital
  5. Jonas Maurer Universitätsspital Bern, Inselspital
  6. Rainer J. Egli Universitätsspital Bern, Inselspital
  7. Frank Michael Klenke Gelenkzentrum Bern
Präsentationsform Poster
Themengebiete
  • A05 - Knie
Abstract Introduction
Multi-ligamentous knee injuries (MLKI) are rare but severe injuries. Different surgical techniques have been described for treatment. Frequently, conservative approaches and surgical reconstruction using auto- or allograft are combined. The aim of this work was to evaluate the mid-term results of primary surgical repair and ligament bracing.
Methods
Twenty-two patients (5 women, 17 men) with a mean age of 45 ± 15 years with MLKI were followed-up at a mean of 49 ± 16 months after surgical treatment including primary repair and ligament bracing. MRI, stress radiographs and outcome scores were obtained. Clinical examination including hop tests and force measurements for flexion and extension was performed.
Results
The mean difference in Tegner score was 2 ± 1 (pre-injury > post-injury). The outcome scores showed mean values of 84 ± 15 (Lysholm), 73 ± 15 (IKDC) and 65 ± 25 (ACL-RSI). The injured knee showed a mean 21 ± 12° lesser range of motion compared to the uninjured knee. Ten patients felt fit enough to perform hop tests and showed a mean deficit of 7 ± 17% compared to the uninjured leg. The mean force deficit was 19 ± 18% for extension and 8 ± 16% for flexion. Stress radiographs revealed 11 ± 7 mm higher anterior-posterior translation on the injured side. Four patients had secondary ligament reconstructions due to persistent instability and seven underwent arthroscopic arthrolysis due to stiffness. A significant increase of osteoarthritis was found for the medial, lateral and patellofemoral compartment (p=0.007, p=0.004, p=0.006).
Conclusion
Primary repair and ligament bracing of MLKI leads to satisfactory clinical mid-term results. Limited persistent radiological instability and a significant increase in osteoarthritis were observed, which is well-known after those injuries. Twenty percent of the patients required secondary reconstruction of specific ligaments.