Outcomes of arthroscopic one-stage repair and reconstruction of Schenck II-IV knee dislocations with multiple ligament injuries: a single-center study.

Objective: To evaluate the outcomes of arthroscopic one-stage repair and reconstruction of Schenck II-IV knee dislocations with multiple ligament injuries.

Methods: We retrospectively reviewed the data of patients with Schenck II-IV knee dislocations and multiple ligament injuries treated in our hospital during 2019-2022. Patients underwent single-bundle reconstruction of the cruciate ligaments via an arthroscopic all-inside technique, along with repair/reconstruction of the collateral ligaments if necessary, and management of concomitant injuries. Knee joint function was evaluated using the International Knee Documentation Committee (IKDC) score, Lysholm score, Tegner activity score, visual analog scale (VAS) score, and range of motion.

Results: All 38 patients (27 men, 11 women; ages, 17-58 years) were followed up for 24-36 months. No postoperative neurovascular or thrombotic complications occurred. For all patients, IKDC (35.76 vs. 83.16, P < 0.001), Lysholm (41.97 vs. 88.63, P < 0.001), Tegner activity (1.18 vs. 6.29, P < 0.001), and VAS scores (3.89 vs.0.21, P < 0.001), and active range of motion (87.08° vs. 126.24°, P < 0.001) were significantly better at the final follow-up than before surgery. The drawer test, Lachman test, pivot shift test, knee varus and valgus stress tests at 0° and 30°, and tibial external rotation test all turned negative after the surgery. Four patients (10.5%) returned to their pre-injury activity levels. All patients achieved grade V muscle strength at 1 year. One patient with preoperative thrombosis underwent anticoagulant treatment and developed no serious complications. A patient with peroneal nerve injury did not experience complications after decompression and postoperative exercises. All meniscus injuries were repaired if indicated.

Conclusions: Acute one-stage arthroscopic reconstruction after knee dislocation with multiple ligament injuries yields satisfactory postoperative knee joint function. This surgical technique can be a treatment option for severe knee injuries.