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Ligament repair and reconstruction in traumatic dislocation of the knee

Middlesbrough General Hospital, Ayresome Green Lane, Middlesbrough TS5 5AZ, UK.

M. J. McNicholas, MD, FRCS (Trauma and Orth), Consultant Trauma and Orthopaedic Surgeon

North Cheshire Hospitals NHS Trust, Warrington General Hospital, Lovely Lane, Warrington, Cheshire WA5 1QG, UK.

J. F. Keating, MPhil, FRCS Ed (Orth), Consultant Orthopaedic Surgeon

Department of Orthopaedic Trauma, Royal Infirmary, Lauriston Place, Edinburgh EF3 9YW, UK.

R. W. Nutton, FRCS, Consultant Orthopaedic Surgeon

Royal Infirmary Edinburgh, Little France, Old Dalkeith Road, Edinburgh EH16 4SU, UK.

Correspondence should be sent to Mr R. Y. L. Liow.

We treated 21 patients with 22 dislocations of the knee by repair or reconstruction of all injured ligaments. Eight knees were treated in the acute phase (less than two weeks after injury); the remainder were treated more than six months after injury (6 to 72). Reconstructions were carried out with a combination of autograft and allograft tendons and by direct ligament repair where possible. At a mean follow-up of 32 months (11 to 77) the mean Lysholm score was 87 (81 to 91) in the acute group and 75 (53 to 100) in the delayed group. The mean Tegner activity rating was 5 in the acute group and 4.4 in the delayed group.

The International Knee Documentation Committee assessment revealed no differences between the two groups. Instrumented testing of knee stability indicated better results for anterior cruciate ligament reconstructions which had been undertaken in the acute phase, but no difference in the outcome of posterior cruciate ligament reconstructions. There was no difference in the loss of knee movement between the two groups. Although the differences were small, the outcome in terms of overall knee function, activity levels and anterior tibial translation were better in those knees which had been reconstructed within two weeks of injury.

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