Article

Knee dislocation and bicruciate lesions are rare. Assessments of
results from retrospective series carry an insufficient level of evidence. A
prospective multicenter study was therefore set up, under the auspices of the
French Society of Orthopedic Surgery.METHODS: The inclusion period
covered the whole of 2007. Clinical, imaging (dynamic X-ray and MRI) and vascular
(angioscan and arteriography) assessment was performed systematically. In
patients over the age of 60 years, ligament lesions were always managed
non-surgically; in those under the age of 60 years, surgery was considered in the
absence of associated vascular lesion or open dislocation and if there was
frontal laxity exceeding 15 degrees or a posterior drawer test greater than 10mm.
The posterior cruciate ligament (PCL) and peripheral ligament tears were repaired
or reinforced under arthroscopy or by arthrotomy. The anterior cruciate ligament
was never operated on. In all other cases, management was conservative. RESULTS:
Sixty-seven knees were included (55 male, 11 female; mean age: 37 years). Fifteen
patients (25.4%) had bicruciate lesion, and 44 (74.6%) knee dislocation. Mean
trauma-to-reduction interval was 3 hrs 50 min. Only one of the nine cases of
popliteal artery lesion exhibited discernible distal pulse wave. Only three of
these patients underwent vascular surgical repair. Twelve knees (five bicruciate
lesions, seven dislocations) had isolated common peroneal nerve damage.
DISCUSSION: This prospective study detailed the epidemiology and treatment of the
lesions encountered, with the option of PCL and peripheral ligament
reconstruction. The results, however, still require long-term analysis.

Langue : FRANCAIS