External fixator for treatment of the sub-acute and chronic multi-ligament-injured knee.
Knee Surg Sports Traumatol Arthrosc
; 23(10): 3012-8, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26289092
ABSTRACT
PURPOSE:
To assess whether the use of an articulated external fixator provides improvements in the mobility, stability and subjective function of patients undergoing ligament reconstruction.METHODS:
Thirty-three patients with sub-acute and chronic knee dislocation were subjected to multi-ligament reconstruction surgery. These patients were randomly allocated to two groups for immobilization after reconstruction group 0-control (18 patients), with rigid knee bracing, and group 1-articulated external fixator (15 patients). The stability of the reconstructed ligaments was assessed after at least 14 months (26.6-month average) postoperatively by physical examination. Deficit of extension and flexion was measured in relation to the unaffected contralateral knee, and the Lysholm knee scoring scale questionnaire was applied.RESULTS:
There was no difference in the assessment of joint stability between the groups. In group 1, patients showed less flexion deficit (4.8° ± 5.4° vs. 18.2° ± 14.8°, p < 0.05), and the percentage of patients with a flexion deficit of 5° or less were higher compared with group 0 (64 vs. 18 %, p < 0.05). There was no difference between groups in relation to extension loss. Group 1 also presented better Lysholm scores, with 73 % of patients rated as excellent or good compared with 35 % in group 0 (p < 0.05).CONCLUSIONS:
Compared with the control rehabilitation protocol with rigid knee bracing in extension, the use of an articulated external fixator in the treatment of chronic multi-ligament-injured knees provided the same ligament stability, better final range of motion and improved Lysholm score. Patients presenting with chronic multi-ligament instability should be considered for articulated external fixation to supplement reconstruction procedures. LEVEL OF EVIDENCE Randomized controlled trial, Level I.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fixadores Externos
/
Procedimentos Ortopédicos
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Procedimentos de Cirurgia Plástica
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Luxação do Joelho
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Traumatismos do Joelho
/
Ligamentos Articulares
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Assunto da revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
ALEMANHA
/
ALEMANIA
/
DE
/
DEUSTCHLAND
/
GERMANY