Epidemiology of complete knee dislocations: an updated classification system
Autor: | Anna Lena Sander, Max Leiblein, Jason-Alexander Hörauf, Lukas Münch, Nils Wagner, Nils Mühlenfeld, Johannes Frank, Philipp Störmann, Ingo Marzi, Daniel P. Berthold |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Knee Dislocation Knee Joint Anterior cruciate ligament Knee Injuries 03 medical and health sciences 0302 clinical medicine Trauma Surgery Dislocations of the knee Multiligament instability Knee surgery Neurovascular damage medicine Humans International Statistical Classification of Diseases and Related Health Problems Orthopedics and Sports Medicine Anterior Cruciate Ligament Retrospective Studies Lateral meniscus 030222 orthopedics business.industry Anterior Cruciate Ligament Injuries Trauma center Retrospective cohort study 030229 sport sciences General Medicine ddc Surgery medicine.anatomical_structure Posterior cruciate ligament Orthopedic surgery Female business Medial meniscus |
Zdroj: | Archives of Orthopaedic and Trauma Surgery. 142:2711-2718 |
ISSN: | 1434-3916 |
Popis: | Introduction Current classifications of complete knee dislocations do not capture the extent of the complex concomitant ligamentous and bony injuries, which may have an impact on future outcomes. The purpose of this retrospective study was to evaluate the epidemiology of complete knee dislocations as well as to present an updated classification system based on the author’s experience at a Level-I trauma center. Materials and methods Only patients with complete loss of contact of the articulating bones and ≥ 18 years of age who admitted in our level-I trauma center between 2002 and 2019 were included. Patients were identified using a retrospective systematical query in the Hospital Information System (HIS) using the International Statistical Classification of Diseases and Related Health Problems Version10 (ICD-10) codes of the German Diagnosis Related Groups (G-DRG). Results Final data included 80 patients, with the majority of patients being male (n = 64; 80.0%). Mean age was 34.9 years (range: 18–70 years). External protective fixation was applied in 32 patients (40.0%). Reconstruction of the posterior cruciate ligament and the anterior cruciate ligament were performed in 56.3% (n = 45) and 55.0% (n = 44) of cases, respectively. The lateral collateral ligament complex was surgically addressed in 47.5% (n = 38), while the medial collateral ligament complex was reconstructed in 40% (n = 32). Surgery of the lateral meniscus and the medial meniscus was needed in 31.1% (n = 25) and 30.0% (n = 24). Neurovascular surgery occurred in 13.8% (n = 11). From the characteristic injury-patterns the authors of this study present a new classification system that ranks the injuries from Grade-A to Grade-D according to their severity. Conclusion This retrospective study demonstrates that the historically used classification systems for dislocations of the knee are insufficient for these severe injuries. Concomitant ligamentous, neurovascular, bony, and meniscal injuries were frequent, and required several staged procedures. Consequently, an updated classification system is proposed. |
Databáze: | OpenAIRE |
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