Quality of Life and Knee Function in Patients with Knee Dislocation

Document Type: Original Article

Authors

Orthopaedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Knee dislocations are uncommon (<0.5% of all dislocations); however, they may result in catastrophic outcomes secondary
to their high‑energy nature and neurovascular injuries. Objectives: The objective of this study was to evaluate the clinical outcome of
knee dislocation management. Subjects and Methods: A total of 20 consecutive adult patients with knee dislocation were enrolled in this
cross‑sectional study between 2011 and 2014. A single knee surgeon examined all the patients for knee instability for subjective evaluation of
knee function using the Lysholm Knee Questionnaire, Knee Society Score (KSS), and Short Form‑36 (SF‑36). Results: The average Lysholm
Knee Scores and KSS were 68 (range: 18–100) and 65 (range: 15–97), respectively. All domains of SF‑36 among the studied patients were
lower than that of the normal population. We could not find any correlation between age, body mass index, and interval between initial trauma
and operation with outcome variables (Lysholm Knee Score, KSS, and SF‑36 Physical Component Score, and SF‑36 Mental Component
Score). Conclusions: The knee function after proper management of dislocation is reasonable, but prolonged course of management and
multiple operations may decrease the patients’ quality of life.

Keywords


1. Seroyer ST, Musahl V, Harner CD. Management of the acute knee dislocation: The Pittsburgh experience. Injury 2008;39:710‑8.

2. Meyers MH, Moore TM, Harvey JP Jr. Traumatic dislocation of the knee joint. J Bone Joint Surg Am 1975;57:430‑3.

3. Taylor AR, Arden GP, Rainey HA. Traumatic dislocation of the knee. A report of forty‑three cases with special reference to conservative treatment. J Bone Joint Surg Br 1972;54:96‑102.

4. Welling RE, Kakkasseril J, Cranley JJ. Complete dislocations of the knee with popliteal vascular injury. J Trauma 1981;21:450‑3.

5. Richter M, Lobenhoffer P, Tscherne H. Knee dislocation. Long‑term results after operative treatment. Chirurg 1999;70:1294‑301.

6. Green NE, Allen BL. Vascular injuries associated with dislocation of the knee. J Bone Joint Surg Am 1977;59:236‑9.

7. Abou‑Sayed H, Berger DL. Blunt lower‑extremity trauma and popliteal artery injuries: Revisiting the case for selective arteriography. Arch Surg 2002;137:585‑9.

8. Rihn JA, Groff YJ, Harner CD, Cha PS. The acutely dislocated knee: Evaluation and management. J Am Acad Orthop Surg 2004;12:334‑46.

9. Walls RM, Rosen P. Traumatic dislocation of the knee. J Emerg Med 1984;1:527‑31.

10. Jacobson KE, Chi FS. Evaluation and treatment of medial collateral ligament and medial‑sided injuries of the knee. Sports Med Arthrosc Rev 2006;14:58‑66.

11. Phisitkul P, James SL, Wolf BR, Amendola A. MCL injuries of the knee: Current concepts review. Iowa Orthop J 2006;26:77‑90.

12. Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ. Reliability, validity, and responsiveness of the Lysholm Knee Scale for various chondral disorders of the knee. J Bone Joint Surg Am 2004;86‑A: 1139‑45.

13. Martimbianco AL, Calabrese FR, Iha LA, Petrilli M, Lira Neto O, Carneiro Filho M, et al. Reliability of the “American Knee Society Score” (AKSS). Acta Ortop Bras 2012;20:34‑8.

14. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF‑36): Translation and validation study of the Iranian version. Qual Life Res 2005;14:875‑82.

15. Jenkinson C, Wright L, Coulter A. Criterion validity and reliability of the SF‑36 in a population sample. Qual Life Res 1994;3:7‑12.

16. Gustilo RB, Cabatan D. Traumatic Dislocation of the Knee. St. Louis, MO: Mosby; 1993.

17. Kennedy JC, Weinberg HW, WilsonAS. The anatomy and function of the anterior cruciate ligament. As determined by clinical and morphological studies. J Bone Joint Surg Am 1974;56:223‑35.

18. Bratt HD, Newman AP. Complete dislocation of the knee without disruption of both cruciate ligaments. J Trauma 1993;34:383‑9.

19. Stannard JP, Sheils TM, Lopez‑Ben RR, McGwin G Jr., Robinson JT, Volgas DA, et al. Vascular injuries in knee dislocations: The role of physical examination in determining the need for arteriography. J Bone Joint Surg Am 2004;86‑A: 910‑5.

20. Nicandri GT, Chamberlain AM, Wahl CJ. Practical management of knee dislocations: Aselective angiography protocol to detect limb‑threatening vascular injuries. Clin J Sport Med 2009;19:125‑9.

21. Barnes CJ, Pietrobon R, Higgins LD. Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta‑analysis. J Trauma 2002;53:1109‑14.

22. Talbot M, Berry G, FernandesJ, Ranger P. Knee dislocations: Experience at the hôpital du Sacré‑Coeur de Montréal. Can J Surg 2004;47:20‑4.

23. Hegyes MS, Richardson MW, Miller MD. Knee dislocation. Complications of nonoperative and operative management. Clin Sports Med 2000;19:519‑43.

24. White J. The results of traction injuries to the common peroneal nerve. J Bone Joint Surg Br 1968;50:346‑50.

25. Wood MB. Peroneal nerve repair. Surgical results. Clin Orthop Relat Res 1991;(267):206-10.

26. Wascher DC. High‑velocity knee dislocation with vascular injury. Treatment principles. Clin Sports Med 2000;19:457‑77.

27. Watanabe H, Urabe K, Takahira N, Ikeda N, Fujita M, Obara S, et al. Quality of life, knee function, and physical activity in Japanese elderly women with early‑stage knee osteoarthritis. J Orthop Surg (Hong Kong) 2010;18:31‑4.

28. Gaweł J, Fibiger W, Starowicz A, Szwarczyk W. Early assessment of knee function and quality of life in patients after total knee replacement. Ortop Traumatol Rehabil 2010;12:329‑37.