title: Are meniscal tears and articular cartilage injury predictive of inferior patient outcome after surgical reconstruction for the dislocated knee?
abstract: OBJECTIVE
  A paucity of data exists on the effects of articular cartilage and meniscal injury in the setting of knee dislocations. The purpose of this study is to determine whether concomitant intra-articular injuries at the time of multiligament reconstruction for knee dislocation are associated with inferior outcomes.
  
  
  METHODS
  The records of patients who underwent surgical treatment for multiligament knee injury between 1992 and 2012 were retrospectively reviewed. Patients included had a PCL-based multiligament knee injury or a minimum of three disrupted ligaments, both indicative of knee dislocation. A logistic regression model was used to determine whether articular cartilage injuries (grade 2 involving ≥50 % of the condylar width or greater, or any grade III/IV lesions) and meniscus tears are predictors of IKDC outcome scores collected at a minimum of 2 years postoperatively.
  
  
  RESULTS
  Of the 121 patients who met inclusion criteria, 2-year minimum follow-up was available on 95 patients (79 %). The cohort was 77 % male and had a median age of 32 years (16-62) at the time of surgery and was followed for an average of 6 years. Articular cartilage injury was present in 40 % of knees: medial femoral condyle (20 %); medial tibial plateau (9 %); lateral femoral condyle (5 %); lateral tibial plateau (4 %); patella (18 %); trochlear (5 %). Meniscal injury was present in 56 % of patients (isolated medial, 22 %; isolated lateral, 22 %; combined, 12 %). IKDC scores were significantly lower for patients with any cartilage damage (p = 0.03), combined medial and lateral meniscus tears (p = 0.02), medial-sided articular cartilage damage (p = 0.03), medial femoral condyle (p = 0.04) and trochlear (p = 0.03) lesions.
  
  
  CONCLUSIONS
  Articular cartilage damage and meniscus tears are frequently associated with a knee dislocation. This study showed IKDC scores were significantly lower for patients with cartilage damage or combined medial and lateral meniscus tears at mid-term follow-up of 6 years.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. King.Alexander@Mayo.edu.
authors.forename: Alexander H
authors.initials: AH
authors.lastname: King
authors.affiliation: Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Krych.Aaron@Mayo.edu.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Krych
authors.affiliation: Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Prince.Matthew@Mayo.edu.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Prince
authors.affiliation: Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Sousa.Paul@Mayo.edu.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Sousa
authors.affiliation: Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Stuart.Michael@Mayo.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stuart
authors.affiliation: Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Levy.Bruce@Mayo.edu.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D000328:Adult; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D031221:Knee Dislocation / Q000209:etiology / Q000601:surgery*; D007718:Knee Injuries / Q000150:complications / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012421:Rupture; D000070600:Tibial Meniscus Injuries; D055815:Young Adult
keywords: Dislocation; Knee; Multiligament; Outcomes; Reconstruction