Epidemiology of complete knee dislocations: an updated classification system

  • 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.

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Author:Nils MühlenfeldORCiDGND, Daniel P. BertholdORCiDGND, Lukas Nawid MünchGND, Philipp StörmannORCiDGND, Jason-Alexander HöraufORCiDGND, Maximilian LeibleinORCiDGND, Anna Lena SanderORCiDGND, Johannes FrankORCiDGND, Ingo MarziORCiDGND, Nils WagnerORCiDGND
Parent Title (English):Archives of orthopaedic and trauma surgery
Place of publication:Berlin ; Heidelberg
Document Type:Article
Date of Publication (online):2021/07/22
Date of first Publication:2021/07/22
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/11/07
Tag:Dislocations of the knee; Knee surgery; Multiligament instability; Neurovascular damage
Page Number:8
First Page:2711
Last Page:2718
Open Access funding enabled and organized by Projekt DEAL.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International