scholarly journals Epidemiology of complete knee dislocations: an updated classification system

2021 ◽  
Author(s):  
Nils Mühlenfeld ◽  
Daniel P. Berthold ◽  
Lukas N. Münch ◽  
Philipp Störmann ◽  
Jason-Alexander Hörauf ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Classification System ◽  
Trauma Center ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Classification Systems ◽  
Collateral Ligament ◽  
Level I ◽  
Knee Dislocations

Abstract Introduction Current classifications of complete knee dislocations do not capture the extent of the complex concomitant ligamentous and bony injuries, which may have an impact on future outcomes. The purpose of this retrospective study was to evaluate the epidemiology of complete knee dislocations as well as to present an updated classification system based on the author’s experience at a Level-I trauma center. Materials and methods Only patients with complete loss of contact of the articulating bones and ≥ 18 years of age who admitted in our level-I trauma center between 2002 and 2019 were included. Patients were identified using a retrospective systematical query in the Hospital Information System (HIS) using the International Statistical Classification of Diseases and Related Health Problems Version10 (ICD-10) codes of the German Diagnosis Related Groups (G-DRG). Results Final data included 80 patients, with the majority of patients being male (n = 64; 80.0%). Mean age was 34.9 years (range: 18–70 years). External protective fixation was applied in 32 patients (40.0%). Reconstruction of the posterior cruciate ligament and the anterior cruciate ligament were performed in 56.3% (n = 45) and 55.0% (n = 44) of cases, respectively. The lateral collateral ligament complex was surgically addressed in 47.5% (n = 38), while the medial collateral ligament complex was reconstructed in 40% (n = 32). Surgery of the lateral meniscus and the medial meniscus was needed in 31.1% (n = 25) and 30.0% (n = 24). Neurovascular surgery occurred in 13.8% (n = 11). From the characteristic injury-patterns the authors of this study present a new classification system that ranks the injuries from Grade-A to Grade-D according to their severity. Conclusion This retrospective study demonstrates that the historically used classification systems for dislocations of the knee are insufficient for these severe injuries. Concomitant ligamentous, neurovascular, bony, and meniscal injuries were frequent, and required several staged procedures. Consequently, an updated classification system is proposed.

scholarly journals The Role of Magnetic Resonance Imaging in Traumatic Knee Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 53-61
Author(s):  
Madan Thapa ◽  
Subash Thapa ◽  
Pramod Kumar Chhetri
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Injury ◽  
Wide Spectrum ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Collateral Ligament

Introduction: Magnetic Resonance Imaging (MRI) as a non-invasive modality plays a vital role in assessment of a wide spectrum of internal knee derangements. This study focuses on the commonest anatomical derangement and reveals the importance of MRI to characterize the pattern of derangement in the assessment of the patient with knee injury. Methods: This is the hospital based prospective study conducted among 65 patients referred to department of radiology with first presentation of knee injury during two years period from August, 2013 to August, 2015. Patient fulfilling the inclusion criteria underwent Magnetic Resonance Imaging knee in SIEMENS MAGNETOM C 0.35 Tesla MRI machine, after taking written informed consent. Descriptive analysis of data was analyzed using SPSS 20.0 program Result: Of the total 65 patients with knee injury, Sport injuries were the most common mode of knee injury. 63 cases with trauma had findings on MRI. Most of the cases presented with joint effusion (59 cases). Anterior Cruciate Ligament (ACL) tear is the commonest injury (37 cases) during knee trauma followed by Medial Collateral Ligament (MCL), Medial Meniscus, Posterior Cruciate Ligament (PCL), Lateral Meniscus and Lateral Collateral Ligament(LCL) injuries. Conclusion: MRI as a high-contrast soft-tissue imaging technique can be used as a noninvasive modality to assess a wide spectrum of internal knee derangements in a patient with knee injury. Specific pattern of bone bruise can guide us to narrow our diagnosis.

Incidence of Associated Knee Lesions with Torn Anterior Cruciate Ligament: Retrospective Cohort Assessment

1998 ◽  
Vol 7 (1) ◽  
pp. 1-8 ◽  
Author(s):  
George A. Arangio ◽  
Edward W. Cohen
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Posterior Oblique Ligament ◽  
Anterior Cruciate Ligament Injuries ◽  
Arcuate Ligament ◽  
Anterior Cruciate

The records of 141 consecutive patients with confirmed complete anterior cruciate ligament injuries were reviewed retrospectively. One hundred and sixty-two associated injuries were divided into 25 injury complexes. Isolated injuries to the anterior cruciate ligament occurred in 40 cases (28.4%). Injuries of the medial meniscus occurred in 62 cases (38.2%), while injuries of the lateral meniscus occurred in 37 cases (22.8%). Injuries to the medial collateral ligament complex occurred in 42 cases (25.9%). Injuries to the lateral collateral ligament, posterior deep popliteus-arcuate ligament complex, and posterior cruciate ligament were found to be positively correlated (rho = .81, p = .001, and rho = .77, p = .001, N = 141, respectively). Injuries to the medial collateral ligament and the posterior oblique ligament were likewise positively correlated (rho = .45, p = .001, N = 141).

Biomechanical Properties of the Stifle Joint Lateral Collateral Ligament in Dogs

1992 ◽  
Vol 05 (04) ◽  
pp. 158-162 ◽  
Author(s):  
D. Blackketter ◽  
J Harari ◽  
J. Dupuis
Keyword(s):  
Mechanical Properties ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Biomechanical Properties ◽  
Fibular Head ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint

Bone/lateral collateral ligament/bone preparations were tested and structural mechanical properties compared to properties of cranial cruciate ligament in 15 dogs. The lateral collateral ligament has sufficient stiffness to provide stifle joint stability and strength to resist acute overload following fibular head transposition.

scholarly journals Imaging Findings of Knee Trauma on Magnetic Resonance Imaging

2022 ◽  
Vol 8 (1) ◽  
pp. 12-23
Author(s):  
Poonam Ohri ◽  
Shreeji Goya ◽  
Niveditha C ◽  
Manasi Kohli
Keyword(s):  
Anterior Cruciate Ligament ◽  
Imaging Modality ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Lateral Collateral Ligament ◽  
Cost Effective ◽  
Collateral Ligament ◽  
Imaging Evaluation ◽  
Young Males ◽  
Anterior Cruciate

Background: Knee is one of the major joints involved in kinesis. With increasing involvement in sports related activities especially in young people, Trauma related knee pathologies have increased. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non-operative treatment. Methods:This prospective study included total of 82 cases. The patients were referred to the department of Radiodiagnosis from indoor and outdoor departments of Guru Nanak Dev Hospital, Amritsar with suspicion of internal derangement of the knee and with history of knee trauma.Results:The most common age group involved was young males between 15-34 years. In all age groups most of the patients were males. Most common ligament to be injured was Anterior Cruciate Ligament (ACL). Partial tears were more common than complete tears. Posterior Cruciate Ligament (PCL) tears were less common. Medial Collateral Ligament (MCL) tears outnumbered Lateral Collateral Ligament (LCL) tears and grade 2 tears were more common in both. Among the meniscal injuries Medial Meniscus (MM) tears were more common than LM and grade 3 signal was more common in both. Most of the patellar retinaculum injuries were associated with Anterior Cruciate Ligament ACL tears.Conclusions:Post-traumatic pre-arthroscopic MR imaging evaluation has proved to be cost-effective. MRI is an accurate imaging modality complementing the clinical evaluation and providing a global intra-articular and extra-articular assessment of the knee.

Deceleration thoracic aortic ruptures in trauma center level I areas: a 6-year retrospective study

2019 ◽  
Vol 45 (6) ◽  
pp. 943-949 ◽  
Author(s):  
Jan Trlica ◽  
Štěpánka Kučerová ◽  
Eva Kočová ◽  
Jaromír Kočí ◽  
Petr Habal ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Trauma Center ◽  
Level I

Radiological Identification of Injury to the Kaplan Fibers of the Iliotibial Band in Association With Anterior Cruciate Ligament Injury

2020 ◽  
Vol 48 (9) ◽  
pp. 2213-2220
Author(s):  
Lachlan M. Batty ◽  
Jerome Murgier ◽  
Julian A. Feller ◽  
Richard O’Sullivan ◽  
Kate E. Webster ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Acl Injury ◽  
Iliotibial Band ◽  
Time Interval ◽  
Collateral Ligament ◽  
Tibial Bone ◽  
Mri Scans ◽  
Anterior Cruciate

Background: Recent biomechanical studies have demonstrated that the Kaplan fibers (KFs) of the iliotibial band play a role in the control of anterolateral rotation of the knee. However, controversy exists regarding whether the KFs are injured in conjunction with anterior cruciate ligament (ACL) injury. Purpose: To establish the prevalence of radiological injury to the KFs in the ACL-injured knee; to evaluate the effect of the time interval between injury and magnetic resonance imaging (MRI) on diagnosis of KF injury; and to assess for any association between KF injury and other qualitative radiological findings. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Preoperative MRI scans were reviewed for 161 patients with ACL injury. Specific diagnostic criteria were developed and applied to identify KF injury. Chi-square testing was performed to look for associations among KF injury, the time from injury to MRI, and associated radiological knee injuries. Results: Radiological evidence of KF injury was identified in 30 (18.6%) patients. The diagnosis of KF injury was higher in patients who had MRI scans performed within 90 days of injury as compared with ≥90 days after injury (23.7 vs 6.4%; P = .010). Patients with an MRI diagnosis of KF injury had significantly higher rates of lateral meniscal injury (40% vs 18%; P = .007), posteromedial tibial bone marrow edema (73% vs 44%; P = .003), and injury to the lateral collateral ligament (13% vs 3%; P = .019) or medial collateral ligament (23% vs 8%; P = .019). Conclusion: The prevalence of injury to the KF in patients with ACL injury as diagnosed by MRI was relatively low (18.6% of patients). However, the time interval from injury to MRI was relevant to diagnosis, with significantly higher rates of injury identification in patients with early (within 90 days) versus delayed (≥90 days) MRI. KF injury was associated with higher rates of injury to the lateral meniscal and collateral ligaments, as well as posteromedial tibial bone bruising.

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