Comparison of surgical repair or reconstruction of the cruciate ligaments versus nonsurgical treatment in patients with traumatic knee dislocations.
BACKGROUND
Studies of traumatic knee dislocations have failed to provide a consensus regarding the best method of treatment.


OBJECTIVE
Our purpose was to evaluate the results after surgical repair or reconstruction versus nonsurgical treatment and to compare the influence of prognostic factors.


METHODS
Retrospective study.


METHODS
Eighty-nine patients were treated for traumatic knee dislocation. Surgical repair or reconstruction of the cruciate ligaments was performed in 63 patients (repair, 49; reconstruction, 14). In 26 patients, nonsurgical treatment was undertaken.


RESULTS
At an average follow-up of 8.2 years, the mean Lysholm and Tegner scores were 75 and 3.7, respectively. The outcome in the surgical group was better than in the nonsurgical group. The scores were higher in patients who were 40 years of age or younger, who had sports injuries rather than motor vehicle accident injuries, and who had undergone functional rehabilitation rather than immobilization.


CONCLUSIONS
Surgical repair or reconstruction of the cruciate ligaments was superior to nonsurgical treatment. Functional rehabilitation was the most important positive prognostic factor. Surgical repair or reconstruction of the cruciate ligaments is mandatory to achieve sufficient stability for functional rehabilitation. In cases of cruciate ligament avulsion, repair with transosseous fixation is a reasonable alternative to reconstruction, provided that it is performed within 2 weeks of trauma.
Richter
Martinus
M
Trauma Department, Hannover Medical School, Hannover, Germany.
Bosch
Ulrich
U
Wippermann
Burkhard
B
Hofmann
Axel
A
Krettek
Christian
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D016009:Chi-Square Distribution; D003663:Decision Trees; D005260:Female; D006801:Humans; D031221:Knee Dislocation / Q000534:rehabilitation / Q000601:surgery / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome