Use of a hinged external knee fixator after surgery for knee dislocation.
OBJECTIVE
This study documents short-term clinical outcomes in patients with knee dislocations after blunt trauma and evaluates the compass knee hinge (CKH) external fixator for their treatment.


METHODS
Nonrandomized prospective functional outcome study.


METHODS
Forty patients with 43 knee dislocations were evaluated. Twelve knees underwent ligament reconstruction followed by placement of a CKH; this was group A. Group B included 27 knees that underwent the same treatment and rehabilitation protocol except that an external brace was used rather than a CKH.


RESULTS
Thirty-six patients with 39 knee dislocations underwent follow-up ranging from 14 to 41 months (mean, 24). Four patients with 4 knee dislocations were lost to follow-up (1 group A, 3 group B). Group A underwent 27 knee ligament procedures with 2 (7%) failures based on clinical examination. Group B underwent 102 ligament procedures with 30 (29%) failures (P <.05). Anterior cruciate ligament (ACL) reconstruction revealed that 7 group A patients experienced 1 (14%) failure and 25 Group B patients experienced 7 (28%) failures. Posterior cruciate ligament (PCL) reconstruction in 7 group A patients included no failures, and 20 PCL reconstructions in group B included 1 failure. Reconstruction of the posterolateral corner (PLC) yielded no failures in 2 group A patients and 5 (25%) of 20 in group B. Repair of 8 PLCs in group A yielded 1 (12.5%) failure and 26 PLC repairs in group B had 14 (54%; P =.05). SF-36 data revealed low mean values with no significant differences between groups with current enrollment.


CONCLUSIONS
Knee dislocation after blunt trauma requires aggressive surgical treatment and physical therapy. In the short-term evaluation, the CKH allows aggressive physical therapy without placing repaired or reconstructed ligaments under high stresses that can result in failure.
Stannard
James P
JP
Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294-3295, USA. James.Stannard@ortho.uab.edu
Sheils
Todd M
TM
McGwin
Gerald
G
Volgas
David A
DA
Alonso
Jorge E
JE
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001178:Arthroplasty; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D031221:Knee Dislocation / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000534:rehabilitation / Q000601:surgery; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000601:surgery