title: Dynamic intraligamentary stabilization and primary repair: a new concept for the treatment of knee dislocation.
abstract: BACKGROUND
  Traumatic knee dislocation represents a rare but devastating injury. Several controversies persist regarding type of treatment, surgical timing, graft selection, repair versus reconstruction of the medial and lateral structures, surgical techniques and postoperative rehabilitation. A new technique for primary ACL stabilization, dynamic intaligamentary stabilization (DIS) was developed at the authors' institution. The purpose of this study was to analyze the clinical and radiological outcomes of surgically treated traumatic knee dislocations by means of the DIS technique for the ACL, primary suturing for PCL, MCL and LCL.
  
  
  METHODS
  Between 2009 and 2012, 35 patients treated surgically for traumatic knee dislocation with primary anterior cruciate ligament (ACL) reconstruction with DIS, suturing of the posterior cruciate ligament (PCL) and primary complete repair of collaterals, were evaluated clinically (IKDC score, SF12 health survey, Lysholm score, Tegner score) and radiologically with a mean follow up of 2.2 years (range 1.00-3.50 years) years. Instrumented anterior-posterior translation was measured (KT-2000).
  
  
  RESULTS
  Anterior/posterior translation (KT-2000) for the healthy and injured limb was 4.8mm (range 3-8mm) and 7.3mm (range 5-10) (89N) respectively. Valgus and varus stress testing in 30° flexion was normal in 26 (75%) and 29 (83%) patients, respectively. The IKDC score was B in 29 (83%) and C in 6 (17%) patients, while the mean Tegner score was 6 (range 4-8). The mean Lysholm score was 90.83 (range 81-95) and mean SF-12 physical and mental scores were 54.1 (range 45-60) and 51.0 (range 39-62) respectively. In 2 patients, a secondary operation was performed.
  
  
  CONCLUSIONS
  Early, one stage reconstruction with DIS can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity without graft requirements.
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
authors.forename: Sandro
authors.initials: S
authors.lastname: Kohl
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Stock
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
authors.forename: Sufian S
authors.initials: SS
authors.lastname: Ahmad
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Zumstein
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
authors.forename: Marius
authors.initials: M
authors.lastname: Keel
authors.affiliation: Department of Emergency Medicine, University of Bern, Switzerland.
authors.forename: Aristomenis
authors.initials: A
authors.lastname: Exadaktylos
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Kohlhof
authors.affiliation: Sonnenhof Orthopaedic Clinics, Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Eggli
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland; 3rd Department of Orthopaedic Surgery, KAT Hospital, University of Athens, Greece. Electronic address: ds.evangelopoulos@gmail.com.
authors.forename: Dimitrios Stergios
authors.initials: DS
authors.lastname: Evangelopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D006801:Humans; D031221:Knee Dislocation / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013536:Suture Techniques; D015599:Trauma Severity Indices; D016896:Treatment Outcome
keywords: Acute ligament repair; Dislocation; Dynamic intraligamentary stabilization; Knee