Long-term clinical and radiological outcomes after multiligament knee injury using a delayed ligament reconstruction approach: A single-center experience

Knee. 2019 Dec;26(6):1271-1277. doi: 10.1016/j.knee.2019.08.009. Epub 2019 Sep 28.

Abstract

Purpose: To present long-term clinical and radiological results of patients treated with delayed reconstruction of multiligament knee injuries.

Methods: Clinical data from 26 patients (21 men, five women, mean age 27.44 years) were retrospectively reviewed. Patients were evaluated at final follow-up with the use of: The International Knee Documentation Committee score (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity level, Lysholm Knee Scoring Scale, EuroQol subjective knee evaluation form, and KT-2000 arthrometer. Mean follow-up time was 105.38 months. Both knees were radiographically evaluated for osteoarthritis according to the Kellgren-Lawrence classification.

Results: No patient required mobilization under anesthesia for adhesion lysis at the immediate or later postoperative duration. There was no statistically significant difference in range of motion between the healthy and operated sides (P = 0.713). Mean time to final range of motion regain was 2.1 ± 0.4 months. Average KT-2000 side-to-side (operated vs. normal) difference was 2.03 ± 1.1 mm, and the difference was statistically significant (P = 0.007). The mean IKDC, KOOS, Lysholm, Tegner, and Euroqol-5D postoperative scores were 82.13 ± 17.5, 84.59 ± 16.8, 90.6 ± 6.4, 4.3 ± 1.3, and 80 ± 11.74, respectively. Multiple regression analysis showed that age and follow-up time had significant effects on each clinical score, except for the Lysholm and Tegner scores. Progression of osteoarthritic changes of the reconstructed knee and its contralateral side was significantly different (P = 0.003).

Conclusion: Excellent clinical results were reported from this center's long-term experience with delayed ligament reconstruction, and osteoarthritic changes of reconstructed knees were recorded.

Keywords: Knee osteoarthritis; Ligament reconstruction; Multiligament knee injury.

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty / methods*
  • Arthroscopy
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / diagnostic imaging
  • Joint Instability / surgery
  • Knee Dislocation / diagnostic imaging
  • Knee Dislocation / etiology
  • Knee Dislocation / surgery
  • Knee Injuries / diagnostic imaging
  • Knee Injuries / surgery*
  • Ligaments, Articular / diagnostic imaging
  • Ligaments, Articular / injuries
  • Ligaments, Articular / surgery*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / surgery*
  • Retrospective Studies
  • Young Adult