Tag Archive for: knee dislocation

Consideration sin the Management of Knee Dislocations in the Limited Resource Setting (KD-LRS)

Dustin L. Richter, Michael MFG Held, Maritz Laubscher, Richard B von Bormann, David North, Sachin Tapasvi, Anshu Shekhar, Daniel C. Wascher, Robert C Schenck

Volume 5 | Issue 1 | Jan – Apr 2020 | Page 66-72

Author: Dustin L. Richter [1], Michael MFG Held [2], Maritz Laubscher [2], Richard B von Bormann [2], David North [2], Sachin Tapasvi [3], Anshu Shekhar [3], Daniel C. Wascher [1], Robert C Schenck [1]

[1] Department of Orthopaedics, University of New Mexico, Albuquerque, USA.
[2] Department of Orthopaedics, University of Cape Town, Cape Town, Sauth Africa.
[3] The Orthopaedic Speciality Clinic in Pune, India

Address of Correspondence
Dr. Dustin L. Richter,
University of New Mexico, MSC10 5600, Albuquerque, NM 87131-0001, United States
E-mail: dlrichter@salud.unm.edu

Abstract

Knee dislocations (KD’s) are an increasingly recognized and potentially devastating injury that crosses between sports medicine and trauma. This intersection of orthopaedic specialities involves differing patient populations with individual challenges. While much of the literature on managing knee dislocations comes from academic centers in economically advantaged countries, the majority of knee dislocations worldwide are treated in limited resource settings (LRS). Even in high income countries, such as the United States, there are significant rural and underserved populations whose available treatment can often mimic LRS in developing nations. Additionally, there are patients with these injuries who refuse allograft reconstructions based on personal or religious beliefs. We have recruited authors with extensive experience in the management of KD’s who also have a special interest in managing the KD patient in the limited resource setting (KD-LRS). Additionally, the LRS environment should not be confused with the quality of professional care provided as the LRS has no limits on human capital.
Our topics will include acute evaluation and management of the KD, management with or without delayed ligament reconstruction, staged management, use of external fixation, reliance on autografts for ligament reconstruction, and management of the neglected KD or delayed presentation. Our goal is to provide a road map, in an area which has very limited references or direction, for the clinician practicing where “less, often has to be more” or utilizing what is available to its greatest capacity.
Keywords/phrases: Limited resource setting (LRS), Knee Dislocation, Neglected KD, Treatment Gap, Autograft KD reconstructions.

References

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How to Cite this article: Richter DL, Held M, Laubscher M, Benno R, North D, Tapasvi S, Shekhar A, Wascher DC, Schenck RC | Considerations in the Management of Knee Dislocations in the Limited Resource Setting (KD-LRS) | Asian Journal of Arthroscopy | January- April 2020; 5(1):66-72.

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Assessment and Decision Making in Acute Knee Dislocation

Dustin L. Richter, Heidi Smith, Marisa Su, Gehron P. Treme, Daniel C. Wascher, Robert C. Schenck

Volume 5 | Issue 1 | Jan – April 2020 | Page 3-8

Author: Dustin L. Richter [1], Heidi Smith [1], Marisa Su [1], Gehron P. Treme [1], Daniel C. Wascher [1], Robert C. Schenck [1]

[1] The University of New Mexico Health Sciences Center

Address of Correspondence
Dr. Dustin L. Richter,
The University of New Mexico, MSC10 5600, Albuquerque, NM 87131-0001, United States
E-mail: dlrichter@salud.unm.edu

Abstract

The traumatic knee dislocation (KD) is a complex condition resulting in injury to more than one ligament or ligament complexes about the knee. Most of the time, KDs result in injury to both cruciate ligaments with variable injury to the collateral ligament complexes. However, there are rare presentations of a single cruciate and collateral ligament injury that present with the tibiofemoral joint dislocated. With the use of the term multi-ligamentous knee injuries (MLKI), it is important to understand that not all MLKIs are KDs. Knees can present in a wide spectrum of severity; from frank dislocation of the tibiofemoral joint to a spontaneously reduced KD, either with or without neurovascular injury. The initial evaluation of these injuries should include a thorough patient history, physical exam and imaging, with particular attention to vascular status which has the most emergent treatment implications. Multiple classification systems have been developed for KDs, with the anatomic classification having the most practical application.
Keywords: Knee dislocation (KD), Multi-ligament knee injury, Assessment, Classification.

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How to Cite this article: Richter DL, Smith H, Su M, Gehron P, Wascher DC, Robert C Schenck RC. Assessment and Decision Making in Acute Knee Dislocation. Asian Journal Arthroscopy. Jan- Apr 2020;5(1):3-8.

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Complications of Multiple Ligament Knee Injury Surgery : Prevention and Salvage

Dinshaw N. Pardiwala, Kushalappa Subbiah, Nandan Rao, Vicky Jain

Volume 5 | Issue 1 | Jan – April 2020 | Page 58-65

Author: Dinshaw N. Pardiwala [1], Kushalappa Subbiah [1], Nandan Rao [1], Vicky Jain [1]

[1] Department of Orthopaedics, okilaben Dhirubhai Ambani Hospital, Mumbai, India.

Address of Correspondence
Dr. Dinshaw Pardiwala,
Kokilaben Dhirubhai Ambani Hospital
Four Bungalows, Andheri (W), Mumbai 400053, India.
E-mail: pardiwala@outlook.com

Abstract

Multiple ligament injuries of the knee are a complex group of injuries with diverse presentations, varying treatment options, and the potential for an array of significant complications. These include iatrogenic neurovascular injuries, fluid extravasation with compartment syndrome, intraoperative technical complications related to tunnel placement and graft tensioning, tourniquet complications, wound problems and infection, venous thromboembolic events, arthrofibrosis with loss of motion, residual knee instability, heterotopic ossification, and missed postoperative knee dislocations. Prevention of these complications is based on a comprehensive knowledge of knee ligament anatomy and biomechanics, understanding the unique and complex nature of these uncommon injuries, detailed preoperative clinico-radiological evaluation, astute surgical planning, careful operative execution, close postoperative monitoring, and a proper rehabilitation program. Early recognition of complications with appropriate and immediate management is critical for satisfactory functional outcomes.
Keywords: Multiple ligament knee injury, Knee dislocation, Complications, Prevention, Salvage, Surgical reconstruction

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How to Cite this article: Pardiwala DN, Subbiah K, Rao N, Jain V | Complications of Multiple Ligament Knee Injury Surgery : Prevention and Salvage | Asian Journal of Arthroscopy | January-April 2020; 5(1): 58-65.

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