J Knee Surg 2021; 34(14): 1495-1502
DOI: 10.1055/s-0040-1710368
Original Article

The Impact of the Ligamentous Injury Pattern and Associated Neurovascular Injury on Ultimate Knee Function in Patients with Traumatic Knee Dislocations

1   Emsey Hospital, Department of Orthopedic Surgery and Traumatology, Yeni Yüzyıl University, Faculty of Health Sciences, Istanbul, Turkey
,
Tuna Pehlivanoglu
1   Emsey Hospital, Department of Orthopedic Surgery and Traumatology, Yeni Yüzyıl University, Faculty of Health Sciences, Istanbul, Turkey
,
Mehmet Demirel
1   Emsey Hospital, Department of Orthopedic Surgery and Traumatology, Yeni Yüzyıl University, Faculty of Health Sciences, Istanbul, Turkey
,
Mechmet Chodza
1   Emsey Hospital, Department of Orthopedic Surgery and Traumatology, Yeni Yüzyıl University, Faculty of Health Sciences, Istanbul, Turkey
,
Halil I. Balcı
1   Emsey Hospital, Department of Orthopedic Surgery and Traumatology, Yeni Yüzyıl University, Faculty of Health Sciences, Istanbul, Turkey
,
Mehmet Asık
1   Emsey Hospital, Department of Orthopedic Surgery and Traumatology, Yeni Yüzyıl University, Faculty of Health Sciences, Istanbul, Turkey
› Author Affiliations

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.



Publication History

Received: 04 June 2019

Accepted: 21 March 2020

Article published online:
27 May 2020

© 2020. Thieme. All rights reserved.

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