管理膝关节多韧带损伤的新算法：三级创伤中心经验

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-07-27 DOI:10.1002/jeo2.70387

Ayman AbdelKawi, Mohammed Fargaly, Gaber Eid, Maher El Assal, Hesham Elkady, Tarek N. Fetih

{"title":"管理膝关节多韧带损伤的新算法：三级创伤中心经验","authors":"Ayman AbdelKawi, Mohammed Fargaly, Gaber Eid, Maher El Assal, Hesham Elkady, Tarek N. Fetih","doi":"10.1002/jeo2.70387","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>Multiligament knee injuries (MLKIs) are severe orthopedic traumas frequently associated with concomitant structural damage, often leading to significant long-term morbidity. This study aimed to evaluate the rate of return to work (RTW) following the management of MLKIs using a standardized treatment algorithm.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This prospective interventional study included patients with MLKIs who presented to a tertiary trauma center between 2019 and 2022. A total of 32 patients (30 males and 2 females) were enrolled and classified according to the Schenck classification system. The median age at the time of injury was 31 years (range: 17–60 years). The mechanism of injury was high-energy trauma in 21 patients, sports-related trauma in eight patients, and low-energy trauma in three patients. Clinical outcomes were assessed at final follow-up using the Lysholm score, International Knee Documentation Committee (IKDC) subjective knee evaluation form, University of California Los Angeles (UCLA) activity score, and return to work status.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>At a mean 2-year postoperative follow-up, the average range of motion across all patients was 134.2° ± 16.6°. The mean postoperative Lysholm, IKDC, and UCLA scores were 86.4 ± 12.6, 65.9 ± 9.7, and 6.9 ± 2.2, respectively. Notably, 90.6% of the patients achieved a successful return to their previous work. The proportion of patients returning to work was significantly higher in the Knee Dislocation Injury (KDI) group compared to the other three Schenck classification groups, which showed no significant difference among themselves. Radiographic evidence of osteoarthritis (OA) was observed in four cases (12.5%).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study demonstrates that satisfactory to excellent short-term clinical outcomes, including a high rate of return to work, can be achieved following ligament reconstruction for multiligament knee injuries when utilizing a standardized treatment algorithm. However, the potential for long-term complications, such as the development of knee osteoarthritis, warrants careful consideration and continued monitoring.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level IV.</p>\n </section>\n </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 3","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70387","citationCount":"0","resultStr":"{\"title\":\"New algorithm for management of multiligament knee injuries: A tertiary level trauma center experience\",\"authors\":\"Ayman AbdelKawi, Mohammed Fargaly, Gaber Eid, Maher El Assal, Hesham Elkady, Tarek N. Fetih\",\"doi\":\"10.1002/jeo2.70387\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>Multiligament knee injuries (MLKIs) are severe orthopedic traumas frequently associated with concomitant structural damage, often leading to significant long-term morbidity. This study aimed to evaluate the rate of return to work (RTW) following the management of MLKIs using a standardized treatment algorithm.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This prospective interventional study included patients with MLKIs who presented to a tertiary trauma center between 2019 and 2022. A total of 32 patients (30 males and 2 females) were enrolled and classified according to the Schenck classification system. The median age at the time of injury was 31 years (range: 17–60 years). The mechanism of injury was high-energy trauma in 21 patients, sports-related trauma in eight patients, and low-energy trauma in three patients. Clinical outcomes were assessed at final follow-up using the Lysholm score, International Knee Documentation Committee (IKDC) subjective knee evaluation form, University of California Los Angeles (UCLA) activity score, and return to work status.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>At a mean 2-year postoperative follow-up, the average range of motion across all patients was 134.2° ± 16.6°. The mean postoperative Lysholm, IKDC, and UCLA scores were 86.4 ± 12.6, 65.9 ± 9.7, and 6.9 ± 2.2, respectively. Notably, 90.6% of the patients achieved a successful return to their previous work. The proportion of patients returning to work was significantly higher in the Knee Dislocation Injury (KDI) group compared to the other three Schenck classification groups, which showed no significant difference among themselves. Radiographic evidence of osteoarthritis (OA) was observed in four cases (12.5%).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>This study demonstrates that satisfactory to excellent short-term clinical outcomes, including a high rate of return to work, can be achieved following ligament reconstruction for multiligament knee injuries when utilizing a standardized treatment algorithm. However, the potential for long-term complications, such as the development of knee osteoarthritis, warrants careful consideration and continued monitoring.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>Level IV.</p>\\n </section>\\n </div>\",\"PeriodicalId\":36909,\"journal\":{\"name\":\"Journal of Experimental Orthopaedics\",\"volume\":\"12 3\",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-07-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70387\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Experimental Orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70387\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Experimental Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70387","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

摘要

目的膝关节多韧带损伤（MLKIs）是一种严重的骨科创伤，常伴有结构损伤，常导致严重的长期发病率。本研究旨在评估使用标准化治疗算法管理mlki后的复工率（RTW）。方法本前瞻性介入研究纳入了2019年至2022年间在三级创伤中心就诊的mlki患者。共纳入32例患者（男30例，女2例），按照Schenck分类系统进行分类。损伤时的中位年龄为31岁（范围：17-60岁）。损伤机制为高能损伤21例，运动相关损伤8例，低能损伤3例。临床结果在最后随访时使用Lysholm评分、国际膝关节文献委员会（IKDC）主观膝关节评估表、加州大学洛杉矶分校（UCLA）活动评分和重返工作状态进行评估。结果在平均2年的术后随访中，所有患者的平均活动范围为134.2°±16.6°。术后Lysholm、IKDC和UCLA平均评分分别为86.4±12.6、65.9±9.7和6.9±2.2。值得注意的是，90.6%的患者成功恢复了以前的工作。膝关节脱位损伤（膝关节脱位损伤）组患者重返工作岗位的比例明显高于其他三个Schenck分类组，但两者之间差异无统计学意义。4例（12.5%）有骨关节炎（OA）的影像学证据。结论本研究表明，采用标准化的治疗算法，对多韧带膝关节损伤进行韧带重建后，可获得满意的短期临床结果，包括较高的复工率。然而，潜在的长期并发症，如膝骨关节炎的发展，需要仔细考虑和持续监测。证据等级四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

New algorithm for management of multiligament knee injuries: A tertiary level trauma center experience

查看原文本刊更多论文

New algorithm for management of multiligament knee injuries: A tertiary level trauma center experience

Purpose

Multiligament knee injuries (MLKIs) are severe orthopedic traumas frequently associated with concomitant structural damage, often leading to significant long-term morbidity. This study aimed to evaluate the rate of return to work (RTW) following the management of MLKIs using a standardized treatment algorithm.

Methods

This prospective interventional study included patients with MLKIs who presented to a tertiary trauma center between 2019 and 2022. A total of 32 patients (30 males and 2 females) were enrolled and classified according to the Schenck classification system. The median age at the time of injury was 31 years (range: 17–60 years). The mechanism of injury was high-energy trauma in 21 patients, sports-related trauma in eight patients, and low-energy trauma in three patients. Clinical outcomes were assessed at final follow-up using the Lysholm score, International Knee Documentation Committee (IKDC) subjective knee evaluation form, University of California Los Angeles (UCLA) activity score, and return to work status.

Results

At a mean 2-year postoperative follow-up, the average range of motion across all patients was 134.2° ± 16.6°. The mean postoperative Lysholm, IKDC, and UCLA scores were 86.4 ± 12.6, 65.9 ± 9.7, and 6.9 ± 2.2, respectively. Notably, 90.6% of the patients achieved a successful return to their previous work. The proportion of patients returning to work was significantly higher in the Knee Dislocation Injury (KDI) group compared to the other three Schenck classification groups, which showed no significant difference among themselves. Radiographic evidence of osteoarthritis (OA) was observed in four cases (12.5%).

Conclusion

This study demonstrates that satisfactory to excellent short-term clinical outcomes, including a high rate of return to work, can be achieved following ligament reconstruction for multiligament knee injuries when utilizing a standardized treatment algorithm. However, the potential for long-term complications, such as the development of knee osteoarthritis, warrants careful consideration and continued monitoring.