Abstract
The present study aims to investigate whether there is a relationship between the
ligamentous injury pattern and concomitant neurovascular injury with long-term functional
outcomes in patients with traumatic knee dislocations (TKDs). A total of 42 patients
with TKDs were categorized according to the Schenck's classification based on the
pattern of ligamentous injury. Concomitant vascular and neural injuries were recorded.
Long-term functional outcomes were assessed using several objective and subjective
outcome measures. This retrospective study was conducted in two phases: (1) to analyze
the impact of ligamentous injury pattern on functional outcomes of patients with TKDs
in the overall study population, by comparing all the variables among Schenck's grades;
(2) to determine the impact of concomitant vascular and neural injury on ultimate
knee function based on the subgroup analyses. In the overall study statistical differences
were determined among each pattern of ligamentous injury in the total range of motion
(ROM) and scoring systems (chi-squared test, p = 0.254). The overall rates of vascular and neural injury were 26 and 28%, respectively.
In subgroup analyses, 40 patients were divided into three subgroups: group A (isolated
concomitant neural injury), group B (isolated concomitant vascular injury), group
C (without concomitant major vascular or neural injury). The analysis revealed a significant
difference in the total ROM (p = 0.005), flexion measurements (p = 0.004), and the loss of extension (p = 0.003). Group A had the lowest total knee ROM and the mean flexion degrees, as
well as the highest loss of extension. Concerning functional scoring systems including
the combined Knee Society Score (knee score + function score), Lysholm knee scoring
scale, and International Knee Documentation Committee score, subgroup analyses revealed
significant differences among the groups (p = 0.001, p < 0.01 for all scores). All the scores were found to be lowest in group A. Evidence
from the current study showed that the ligamentous pattern and concomitant neurovascular
injury both may have a significant impact on ultimate knee function in patients with
TKDs. This is a Level III-retrospective comparative study.
Keywords traumatic knee dislocation - ligamentous injury pattern - concomitant neurovascular
injury - ultimate knee function
