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KMID : 1037920140010020111
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Arthroscopy and Orthopedic Sports Medicine
2014 Volume.1 No. 2 p.111 ~ p.119
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Staged surgical management of multiple ligament injury of the knee
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Suh Jeung-Tak
Ahn Jae-Min
Lee Ji-Min
Kim Nu-Ri
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Abstract
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Background: We evaluated the clinical outcomes of staged surgical management of patients with multiple ligament injury of the knee after a follow-up period of at least one year.
Methods: A staged surgical management of 20 cases of multiple ligament injury of the knee in 18 patients was carried out between January 2005 and December 2010 and followed up for a minimum of 1 year. All multi-ligament injuries were either KD-II or above injuries according to the modified Scheneck classification system. As the first stage of management, repair or reconstruction were performed for all cases of posterolateral ligament complex injuries; conservative treatment for 5 cases of medial collateral ligament injuries with low grade (grade 1 or 2), and suturing for 6 cases with high grade (grade 3). If instability persisted even when the patient’s range of motion returned to normal levels, as a second stage of management, the fresh-frozen Achilles allograft was used for trans-tibial single bundle reconstruction by arthroscopy.
Results: The mean Lysholm score improved from 52.1 ± 5.53 (range, 43-62) preoperatively to 88.3 ± 5.61 (range, 78-95) at the last follow-up. The Lysholm score was above 80 points in 90.0% of the knees (18 out of 20). The mean International Knee Documentation Committee (IKDC) subjective score also improved from 45.3 ± 11.52 (range, 29.1-67.3) preoperatively to 86.4 ± 10.33 (range, 66.5-99.5) at the last follow-up. The overall IKDC grading was above B in 70% of the knees (14 out of 20). Lastly, the Tegener activity score improved from 2.9 ± 0.62 (range, 2-4) preoperatively to 4.6 ± 0.86 (range, 3-6) at the last follow-up.
Conclusion: We obtained satisfactory clinical results after a staged surgical management of multiple ligament injury of the knee. Therefore, we suggest staged surgical management as one of the treatment options for multiple ligament injury of the knee.
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KEYWORD
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Multiple ligament injury of the knee, Knee dislocation, Staged surgical management
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