scholarly journals Open knee dislocation with a patellar tendon rupture: Result of staged surgical repair

2019 ◽  
Vol 7 ◽  
pp. 2050313X1882310
Author(s):  
Tsuneari Takahashi ◽  
Tomohiro Matsumura ◽  
Kazuaki Ishihara ◽  
Shuhei Hiyama ◽  
Katsushi Takeshita
Keyword(s):  
Posterior Cruciate Ligament ◽  
Surgical Management ◽  
Patellar Tendon ◽  
Tendon Rupture ◽  
Cruciate Ligament ◽  
Knee Dislocation ◽  
Patellar Tendon Rupture ◽  
Collateral Ligament ◽  
Range Of Movement ◽  
Multiligament Injury

Knee dislocation with concomitant multiligament injury is a rare and devastating injury. We report the successful repair of a rare case of open knee dislocation with concomitant multiligament injury and patellar tendon rupture of an 18-year-old male due to a motorcycle accident. The patient presented with an open wound running parallel to the knee joint line and patellar tendon rupture with full exposure of the cartilage of the distal femur. Staged surgical management including the application of a ring-type external fixator with a hinged joint, lateral collateral ligament repair, medial collateral ligament reconstruction using autogenous hamstring tendon, and joint release was performed. Range of movement was recovered to 0 degrees of knee extension and 80 degrees of knee flexion, and extension lag was negative. The Lysholm score of the patient was recovered to 92. The patient was able to return to work in the construction field 2 years after sustaining the injury. The patient had no complaint of pain and was able to resume construction work, even though reconstruction of the anterior cruciate ligament and posterior cruciate ligament was not performed. The application of a hinged ring-type external fixation device might play a key role in early range of movement restoration and to maintain the reduced position and acceptable recovery of the posterior cruciate ligament injury without the need for reconstructive surgery. This report is the first to describe the safety and effectiveness of staged surgical management for the repair of open knee dislocation with concomitant multiligament injury and patellar tendon rupture. However, further studies with longer follow-up periods will be needed to observe the development of osteoarthritis or weakness of the knee. Staged surgical management is a safe and effective procedure for repairing an open knee dislocation with concomitant multiligament injury and patellar tendon rupture.

scholarly journals Single-Stage Arthroscopic Anterior and Posterior Cruciate Ligament Repairs and Open Medial Collateral Ligament Repair for Acute Knee Dislocation

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ryo Murakami ◽  
Eisaburo Honda ◽  
Atsushi Fukai ◽  
Hiroki Yoshitomi ◽  
Takaki Sanada ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Knee Dislocation ◽  
Single Stage ◽  
Lateral Condyle ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Medial Condyle

Till date, there are no clear guidelines regarding the treatment of multiple ligament knee injuries. Ligament repair is advantageous as it preserves proprioception and does not involve grafting. Many studies have reported the use of open repair and reconstruction for multiple ligament knee injuries; however, reports on arthroscopic-combined single-stage anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) repairs are scarce. In this report, we describe a case of type III knee dislocation (ACL, PCL, and medial collateral ligament (MCL) injuries) in a 43-year-old man, caused by contact while playing futsal. On the sixth day after injury, arthroscopic ACL and PCL repairs were performed with open MCL repair. The proximal lesions in the three ligaments that were injured were sutured using no. 2 strong surgical sutures. The ACL was pulled out to the lateral condyle of the femur and fixed using a suspensory fixation device. The PCL was pulled out to the medial condyle of the femur, and the MCL was pulled towards the proximal end of the femur; both were fixed using suture anchors. Early mobilization was performed, and both, clinical and imaging outcomes, were good two years after surgery.

Reconstruction of the Lateral Collateral Ligament of the Knee With Patellar Tendon Allograft

1998 ◽  
Vol 26 (5) ◽  
pp. 656-662 ◽  
Author(s):  
Harrison A. Latimer ◽  
James E. Tibone ◽  
Neal S. ElAttrache ◽  
Patrick J. McMahon
Keyword(s):  
Posterior Cruciate Ligament ◽  
Patellar Tendon ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Surgical Reconstruction ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Lachman Test ◽  
Test Result

This is a retrospective study of 10 patients with combined cruciate ligament and posterolateral instability who underwent surgical reconstruction between 1991 and 1994. All knees had at least 20° increased external rotation at 30° of knee flexion and from 1 to 3 varus instability. Five knees with posterior cruciate ligament ruptures had at least a 2 Lachman test result. (One knee had both anterior and posterior cruciate ligament injuries.) In all cases the lateral collateral ligament was reconstructed with a bone-patellar tendon-bone allograft secured with interference screws. Fixation tunnels were placed in the fibular head and at the isometric point on the femur. The cruciate ligaments were reconstructed with autograft or allograft material. The average follow-up was 28 months. Excessive external rotation at 30° of flexion was corrected in all but one knee. Six patients had no varus laxity, and four patients had 1 varus laxity at 30° of flexion. The posterior drawer test result decreased, on average, to 1 , and the Lachman test result decreased to between 0 and 1 . The average Tegner score was 4.6, with five patients returning to their preinjury level of activity and four returning to one level lower. These results indicate that this is a promising new procedure for patients with instability resulting from lateral ligament injuries of the knee.

scholarly journals Knee sliced open by skate blade: complete patellar tendon rupture in an elite long track speed skater

2019 ◽  
Vol 12 (4) ◽  
pp. e228611
Author(s):  
Alexander Nagel Tandberg ◽  
Hege Grindem ◽  
Christian Wiig ◽  
Wender Figved
Keyword(s):  
Patellar Tendon ◽  
Tendon Rupture ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Suture Repair ◽  
Partial Rupture ◽  
Patellar Tendon Rupture ◽  
Transosseous Suture ◽  
Anterior Cruciate ◽  
The Right

A long track speed skater sustained a deep horizontal cut to the right knee just distally to the patella, after he got hit by the skate blade of the pair mate. The injury included a complete patellar tendon rupture from the apex of the patella, a 1 mm deep transverse cut in the femoral condyle and a partial rupture of the anterior cruciate ligament. The tendon rupture was repaired with transosseous suture repair without augmentation. A knee brace was used for 8 weeks, with a gradual decrease in flexion restraints. A rehabilitation programme was overseen by a dedicated physiotherapist. At 6 months, he started a gradual return to skating sessions. After 1 year, he had symmetrical single-legged hop performance, but quadriceps weakness due to pain. The patient returned to competition speed skating at national levels after 11 months, and within the first postoperative year, he was breaking new personal records on the ice.

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