Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature Review

Irreducible knee dislocations (KDs) are rare and challenging traumatic injuries requiring surgical intervention for joint reduction. This study presents the largest case series in English literature to date on irreducible KDs, aiming to analyze etiology, contributing causes to irreducibility, and tr...

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Main Authors: Meng-Xiu Lee, Wei-Li Chen, Chi-Sheng Chien, Tsung-Mu Wu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-04-01
Series:Formosan Journal of Musculoskeletal Disorders
Subjects:
Online Access:https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00010
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author Meng-Xiu Lee
Wei-Li Chen
Chi-Sheng Chien
Tsung-Mu Wu
author_facet Meng-Xiu Lee
Wei-Li Chen
Chi-Sheng Chien
Tsung-Mu Wu
author_sort Meng-Xiu Lee
collection DOAJ
description Irreducible knee dislocations (KDs) are rare and challenging traumatic injuries requiring surgical intervention for joint reduction. This study presents the largest case series in English literature to date on irreducible KDs, aiming to analyze etiology, contributing causes to irreducibility, and treatment protocols employed. We included 35 patients with irreducible KDs who underwent surgical treatment between January 2006 and December 2021. Data on demographics, injury characteristics, dislocation direction, ligament injuries, contributing factors to irreducibility, associated injuries, treatment methods, hospital stay, complications, and latest follow-up ambulatory status were recorded. Patients were classified using the Schenck classification system. Posterolateral dislocation was most common, accounting for 60% of cases. Road traffic accidents caused 65.7% of injuries, followed by sports injuries (17%). Injuries primarily involved the medial retinaculum, capsule, and medial collateral ligament (MCL) (94%). KD III-M, involving the anterior cruciate ligament, posterior cruciate ligament, and MCL, was the most common injured ligament pattern (40%). The medial parapatellar approach was utilized for reduction and surgical repair when necessary. 65.7% of cases underwent conservative therapy with immobilization and rehabilitation, while 34.3% received ligament repair or reconstruction. At the latest follow-up, all patients were able to walk without ambulatory support, with no progression to amputation, knee arthrodesis, or total knee arthroplasty. This study contributes to understanding the rare irreducible KD in southern Taiwan population. High-energy trauma, notably scooter accidents, significantly impacted the injury pattern in this population. The conservative approach and tailored treatment strategies were effective in achieving functional and stable knees.
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spelling doaj-art-52888e4c536743a7a0d79d43a7b89e802025-08-20T02:16:22ZengWolters Kluwer Medknow PublicationsFormosan Journal of Musculoskeletal Disorders2210-79402210-79592024-04-01152717810.4103/fjmd.FJMD-D-23-00010Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature ReviewMeng-Xiu LeeWei-Li ChenChi-Sheng ChienTsung-Mu WuIrreducible knee dislocations (KDs) are rare and challenging traumatic injuries requiring surgical intervention for joint reduction. This study presents the largest case series in English literature to date on irreducible KDs, aiming to analyze etiology, contributing causes to irreducibility, and treatment protocols employed. We included 35 patients with irreducible KDs who underwent surgical treatment between January 2006 and December 2021. Data on demographics, injury characteristics, dislocation direction, ligament injuries, contributing factors to irreducibility, associated injuries, treatment methods, hospital stay, complications, and latest follow-up ambulatory status were recorded. Patients were classified using the Schenck classification system. Posterolateral dislocation was most common, accounting for 60% of cases. Road traffic accidents caused 65.7% of injuries, followed by sports injuries (17%). Injuries primarily involved the medial retinaculum, capsule, and medial collateral ligament (MCL) (94%). KD III-M, involving the anterior cruciate ligament, posterior cruciate ligament, and MCL, was the most common injured ligament pattern (40%). The medial parapatellar approach was utilized for reduction and surgical repair when necessary. 65.7% of cases underwent conservative therapy with immobilization and rehabilitation, while 34.3% received ligament repair or reconstruction. At the latest follow-up, all patients were able to walk without ambulatory support, with no progression to amputation, knee arthrodesis, or total knee arthroplasty. This study contributes to understanding the rare irreducible KD in southern Taiwan population. High-energy trauma, notably scooter accidents, significantly impacted the injury pattern in this population. The conservative approach and tailored treatment strategies were effective in achieving functional and stable knees.https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00010irreducible knee dislocationmultiligament knee injuryposterolateral knee dislocationschenck classification
spellingShingle Meng-Xiu Lee
Wei-Li Chen
Chi-Sheng Chien
Tsung-Mu Wu
Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature Review
Formosan Journal of Musculoskeletal Disorders
irreducible knee dislocation
multiligament knee injury
posterolateral knee dislocation
schenck classification
title Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature Review
title_full Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature Review
title_fullStr Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature Review
title_full_unstemmed Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature Review
title_short Causes and Management of Irreducible Knee Dislocation Injuries: A Single-center Case Series and Literature Review
title_sort causes and management of irreducible knee dislocation injuries a single center case series and literature review
topic irreducible knee dislocation
multiligament knee injury
posterolateral knee dislocation
schenck classification
url https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00010
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AT chishengchien causesandmanagementofirreduciblekneedislocationinjuriesasinglecentercaseseriesandliteraturereview
AT tsungmuwu causesandmanagementofirreduciblekneedislocationinjuriesasinglecentercaseseriesandliteraturereview