Allograft reconstruction of the anterior and posterior cruciate ligaments after traumatic knee dislocation.
Seven patients (average age, 26.3 years) with traumatic knee dislocations were retrospectively evaluated more than 2 years (average, 51 months) after having fresh-frozen allograft anterior and posterior cruciate ligament reconstructions. All patients were treated consecutively at an average of 9.6 days after injury. Two patients had arterial injuries and three patients had or developed common peroneal nerve palsy. Five patients had 20 additional injuries. All patients were enlisted in an early, aggressive physical therapy regimen with early protected weightbearing. Four patients required a manipulation under anesthesia for arthrofibrosis at an average of 16.8 weeks postoperatively (range, 6 to 33 weeks). At followup, only one patient had significant pain, three patients had rare or occasional giving way, and all seven were able to return to school or to the workplace. The functional grading was excellent in three patients, good in three patients, and fair in one patient. No patient had a significant flexion contracture; the average flexion arc was 118 degrees (range, 105 degrees to 135 degrees). Knee dislocation is a very traumatic injury, often resulting in a painful, dysfunctional knee. Anterior and posterior cruciate ligament reconstructions in young, active patients can minimize pain and optimize functional outcome. Arthrofibrosis is a common occurrence in these patients, and manipulation under anesthesia is frequently required.
Shapiro
M S
MS
Department of Orthopaedic Surgery, University of California Los Angeles Medical Center 90024, USA.
Freedman
E L
EL
D000063:Accidents, Traffic; D000125:Achilles Tendon / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000792:Angiography; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000209:etiology; D004204:Joint Dislocations / Q000534:rehabilitation / Q000601:surgery*; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D010329:Patella; D010543:Peroneal Nerve / Q000293:injuries; D011150:Popliteal Artery / Q000293:injuries; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome