title: The timing of surgical treatment of knee dislocations: a systematic review.
abstract: OBJECTIVE
  Traumatic knee dislocations (KDs) are unusual yet limb-threatening injuries; the timing of surgical intervention is still debated. A systematic review was performed to determine the optimal timing of surgery with respect to injury pattern.
  
  
  METHODS
  A comprehensive search of Medline, EMBASE, and Cochrane Central Register of Controlled Trials was performed for studies published between 1 January 1974 and 20 April 2014 on the surgical management of "knee dislocation" and "multiligament knee injuries". Surgical timing was classified as acute, chronic, or staged. A systematic review was performed for patients with KD-III according to Schenck's classification using individual patient data.
  
  
  RESULTS
  Twelve studies including 150 patients (153 knees) with KDs fulfilled the study requirements. Sixty-nine cases with KD-IIIM and 84 cases with KD-IIIL were identified. Excellent or good results were demonstrated in 79.1 % (34 cases) of cases managed with staged treatment versus 58.4 % (45 cases) of cases undergoing acute surgery (p = 0.02), and versus 45.5 % (15 cases) of cases undergoing chronic surgery (p = 0.002). No statistically significant difference was found in the percentage of excellent or good results between the acute and chronic surgery groups (n.s.), or between the KD-IIIM and KD-IIIL groups (n.s.).
  
  
  CONCLUSIONS
  Staged treatment yields the best clinical results for patients with KD-III. No statistically significant difference was shown in the clinical results between acute surgery and chronic surgery groups.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedics, General Hospital of Beijing Military Command, Dongcheng District, Nanmencang No. 5, Beijing, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, General Hospital of Beijing Military Command, Dongcheng District, Nanmencang No. 5, Beijing, China. drjianhuayao@163.com.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yao
authors.affiliation: Department of Oncology, Nanfang Hospital, Baiyun District, Guangzhou Avenue No. 1838, Guangzhou, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Orthopaedics, General Hospital of Beijing Military Command, Dongcheng District, Nanmencang No. 5, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Orthopaedics, General Hospital of Beijing Military Command, Dongcheng District, Nanmencang No. 5, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Clinical College of Integrated Chinese and Western Medicine, Anhui University of Chinese Medicine, Shushan District, Meishan Road No. 70, Hefei, China.
authors.forename: Dejia
authors.initials: D
authors.lastname: Kong
mesh_terms: D006801:Humans; D031221:Knee Dislocation / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery*; D061646:Operative Time; D019637:Orthopedic Procedures / Q000379:methods*
keywords: Knee dislocation; Multiligament knee injuries; Surgical timing; Systematic review