Description
Retrospective and consecutive series of MLKI on skeletally mature patients operated on in a single public and university level I trauma center from 2010 to 2020. Patients with prior surgery or other non-traumatic issues around the knee were excluded. A postoperative follow-up period of one year was considered, including periodical clinical and radiological evaluations. Patients underwent a staged treatment. Data on patient’s baseline characteristics, injuries, treatments, and results were recorded. For clinical evaluation, the patient recorded outcome measures were the Tegner-Lysholm Knee Scoring Scale (TLKSS), the return to previous work and an overall satisfaction scale.
24 patients were available for analysis, representing an incidence of 0.03% over all trauma-related admissions during the study period. They were 8 female and 16 male patients with a median age of 43.6 years. 16 were related to high-energy trauma (road accidents and sports) and 8 to low-energy trauma. The mean Injury Severity Score (ISS) was 12.6 and the involvement of visceral or other skeletal structures was frequent. 5 out of 24 (20.9%) presented with a knee dislocation requiring emergent reduction, 6 sustained a fracture around the knee (25%) and 2 were open fractures. External fixation was used for the initial stabilization in 7 cases (29.2%).
There were one popliteal artery injury requiring a bypass and four common peroneal nerve palsies. A staged treatment ligamental reconstruction was performed in all cases. There were seven postoperative complications. The median TLKSS was 80 and 23 patients (95.8%) were satisfied or very satisfied with the results of the reconstruction. Polytrauma patients with a higher ISS were associated with worse results in the postoperative Tegner - Lysholm test. An associated fracture around the knee was related with a worse result in the knee functionality questionnaire, return to work and satisfaction with the intervention, satisfaction in relation to the pain, satisfaction in relation to the usual work and satisfaction in relation to recreational activities, statistically non-significant results.17 patients (70.8%) returned to their previous job.
