Acute surgical management of traumatic knee dislocations — Average follow-up of 10 years

• We present a long-term follow-up of acute surgical management for traumatic knee dislocations.
• Acute surgical management demonstrates satisfactory long-term outcomes.
• We demonstrate our surgical algorithm when managing such injuries.
• Large cohort of traumatic knee dislocations with long term follow-up
• Acute surgical management allows early rehabilitation with 56% of patients achieving a near normal knee.

BackgroundTraumatic knee dislocations have been managed historically by means of either delayed reconstruction or non-operative methods. More recently, there has been a trend towards early reconstruction. There is no clear consensus in the literature as to how such patients should be managed and in what time frame.ObjectiveThe aim of this study was to establish the long-term outcome of patients who underwent acute surgical management of their traumatic knee dislocation.MethodsThirty-six patients with traumatic knee dislocations were treated by multi-ligament reconstruction. All surgical interventions occurred within 21 days of presentation. The collateral ligament complexes were primarily repaired where possible and reconstructions were performed with either autograft, allograft or the ligament augmentation and reconstruction system (LARS) synthetic graft.ResultsThe mean time to surgery was 12 days (1 to 21) with a mean follow-up of 10.1 years (7 to 19). The International Knee Documentation Committee (IKDC) assessment demonstrates that 56% of patients went on to have “nearly normal” knee function and the average Tegner–Lysholm score of 80 (57 to 91), is consistent with good function. The Knee Outcome score (KOS) was 84% for Activities of Daily Living and 74% for Sports.ConclusionThis study demonstrates a high level of overall knee function following the acute surgical reconstruction of traumatic knee dislocations.Level of evidenceLevel 2B: Cohort Study with Outcome Measures.