title: Early operative reconstruction of severe ligamentous knee injuries in patients with multiple trauma.
abstract: Although operative reconstruction of severe knee ligament injuries has been the preferred method of treatment, the timing of that reconstruction relative to the injury has not been previously addressed. In a retrospective review of multitrauma cases, we identified 32 patients with 34 severe knee ligament injuries. Of these 34 knees, 19 (56%) were treated with early reconstruction (within 2 weeks of injury). Of the remaining 15 knees, 8 were managed by delayed reconstruction at an average of 4.8 months after injury, and 7 knees were not surgically treated. All 19 knees treated by early operation were clinically stable, and 89% were pain free at an average of 25 months' follow-up. In contrast, only 13% of the knees treated by delayed or no reconstruction were clinically stable, 33% were persistently painful, and 40% required bracing intermittently to allow activities of daily living. In this study, patients treated by delayed reconstruction or non-operatively had poor functional results. We believe early operative reconstruction of severe knee injuries in multitrauma patients is crucial to maximize functional outcome and minimize long-term sequelae.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tenn 37232-2550, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Limbird
authors.forename: W B
authors.initials: WB
authors.lastname: Garside
authors.forename: D B
authors.initials: DB
authors.lastname: Richards
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007718:Knee Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome