Scoring systems for outcome after knee injuries

Abstract

Outcome assessment after knee injuries and periarticular fractures are not well described in the literature. This review focuses on outcome assessment, specifically surveying various scoring systems after knee trauma. Additionally, we include a report on a series of 637 patients with multiple injuries that were re-examined at least 10 years after the inciting incident. The series includes 48 patients with lower extremity injuries isolated to the knees, and for comparison, 107 poly-traumatized patients with femoral diaphyseal fractures and no other lower extremity injuries. The outcomes were assessed utilizing the Lysholm score, the Tegner activity score, the Hannover Score for Polytrauma Outcome (HASPOC), and the 12-item short-form health survey (SF-12). We calculated correlation coefficients to compare the general health questionnaires with the more specific knee scores. For the comparison of knee injured patients with femoral shaft fracture patients, we applied the Wilcoxon test. With respect to the Tegner activity score, we observed deterioration from a mean preoperative score of 5.0, to 2.8 points at follow up. The mean Lysholm score was 81.97, ranging from 15 to 100 points. However, there was no correlation between results obtained from the Lysholm score with the results of the general health questionnaires. Although not statistically significant, the general health questionnaires (HASPOC and SF-12) trended towards a less favourable outcome for polytraumatized patients who sustained a knee injury in comparison to those with a femoral shaft fracture. In conclusion, the outcomes of knee injuries in poly-traumatized patients are rather heterogeneous, but generally are worse than in those with lower extremity injuries that spare the knee joint.