Orthopaedic journal of sports medicine · 2026
One-Stage Arthroscopic Reduction Combined With Reconstruction of Knee Stability for Irreducible Knee Dislocation: A 2-Year Follow-up Study.
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Sun Yang, Zhao Wei, Ma Shengshan, Li He, Wu Dongze, Li Xiaofei
Аннотация
BACKGROUND: Irreducible knee dislocation (IKD) is a rare but severe injury, accounting for approximately 4% of all knee dislocations and characterized by soft tissue incarceration that precludes closed reduction. Current management remains debated, particularly regarding the optimal timing of ligament reconstruction (single- vs. two-stage) and the choice of surgical approach.
PURPOSE: To investigate the short-term efficacy and outcomes of 1-stage arthroscopic reduction combined with reconstruction of knee stability for irreducible knee dislocation (IKD).
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: A total of 16 patients with IKD, treated with 1-stage arthroscopic surgery between June 2015 and July 2022, were included in this study. The surgery involved arthroscopic knee reduction and simultaneous multiligament reconstruction or repair. Side-to-side differences determined with a KT-1000 arthrometer and physical examinations-including the Lachman test, the pivot shift test, the drawer test, and the varus and valgus stress test-were performed for the evaluation of knee joint stability. Other assessments included the International Knee Documentation Committee (IKDC) score, the Lysholm score, pain scores, and satisfaction scores. A paired t test was used to determine the difference between the pre- and postoperative clinical outcomes.
RESULTS: One patient experienced traumatic redislocation at 1 month due to noncompliance with bracing and was excluded from functional outcome analysis. The remaining 15 patients completed a 2-year follow-up. For all patients included in this study, the mean time from injury to surgery was 5.5 ± 1.4 days, and the mean follow-up time was 27.4 ± 2.6 months. At the last follow-up, all patients had normal or nearly normal Lachman, pivot shift, drawer, and varus and valgus stress tests. The IKDC score was 76.07 ± 2.84 (range, 70-82), the Lysholm score was 81.87 ± 4.22 (range, 74-87), and the pain score was 1±1 (range, 0-3). The satisfaction score was 8.53 ± 0.74 (range, 7-10), which significantly improved compared with the preoperative score (P < .05). No severe complications-including infection, compartment syndrome, neurovascular complications, graft ruptures, or deep vein thrombosis -were observed during follow-up.
CONCLUSION: One-stage arthroscopic reduction, combined with reconstruction of knee stability, can effectively restore knee stability and improve clinical outcomes in the treatment of IKD.
PURPOSE: To investigate the short-term efficacy and outcomes of 1-stage arthroscopic reduction combined with reconstruction of knee stability for irreducible knee dislocation (IKD).
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: A total of 16 patients with IKD, treated with 1-stage arthroscopic surgery between June 2015 and July 2022, were included in this study. The surgery involved arthroscopic knee reduction and simultaneous multiligament reconstruction or repair. Side-to-side differences determined with a KT-1000 arthrometer and physical examinations-including the Lachman test, the pivot shift test, the drawer test, and the varus and valgus stress test-were performed for the evaluation of knee joint stability. Other assessments included the International Knee Documentation Committee (IKDC) score, the Lysholm score, pain scores, and satisfaction scores. A paired t test was used to determine the difference between the pre- and postoperative clinical outcomes.
RESULTS: One patient experienced traumatic redislocation at 1 month due to noncompliance with bracing and was excluded from functional outcome analysis. The remaining 15 patients completed a 2-year follow-up. For all patients included in this study, the mean time from injury to surgery was 5.5 ± 1.4 days, and the mean follow-up time was 27.4 ± 2.6 months. At the last follow-up, all patients had normal or nearly normal Lachman, pivot shift, drawer, and varus and valgus stress tests. The IKDC score was 76.07 ± 2.84 (range, 70-82), the Lysholm score was 81.87 ± 4.22 (range, 74-87), and the pain score was 1±1 (range, 0-3). The satisfaction score was 8.53 ± 0.74 (range, 7-10), which significantly improved compared with the preoperative score (P < .05). No severe complications-including infection, compartment syndrome, neurovascular complications, graft ruptures, or deep vein thrombosis -were observed during follow-up.
CONCLUSION: One-stage arthroscopic reduction, combined with reconstruction of knee stability, can effectively restore knee stability and improve clinical outcomes in the treatment of IKD.