Chronic multiple knee ligament injuries: epidemiological analysis of more than one hundred cases

INTRODUCTION: Diagnosis and treatment of multiple ligament injuries of the knee remain a real challenge for most surgeons. OBJECTIVE: To find out the epidemiological profile of patients surgically treated at a Reference Service with more than one chronic ligament injury in the knee joint. MATERIALS AND METHODS: Of a total of 978 operated patients, 109 presented at least two associated ligament injuries in the same knee. Demographic and clinical variables were evaluated. RESULTS: The anterior cruciate ligament group presented a larger number of cases of ligament injuries related with sports practice and falls, while the posterior cruciate ligament and anterior cruciate ligament + posterior cruciate ligament groups presented more cases related to traffic accidents and trauma with object (weight on the knee) (p<0.001). The varus group presented significantly higher values of time since injury (p<0.01). In the group with new anterior cruciate ligament injury (neoligament) associated with other ligament injuries the disruption times were higher, showing statistical significance (p<0.001). CONCLUSIONS: Anterior cruciate ligament injury associated with other ligament injuries other than posterior cruciate ligament injury are related to sports practice and falls. Posterior cruciate ligament injury associated to other ligament injuries, including or not anterior cruciate ligament injury, are related to traffic accidents and direct trauma caused by an object on the knee. Significant delay between primary ligament injuries and their reconstructions generates varus deformity of the affected knee. In spite of the large delay in seeking medical treatment, few patients with neoligament anterior cruciate ligament injury and other combined disruptions will develop varus deformity.

Conseqüências tardias das lesöes isoladas e näo tratadas do ligamento cruzado posterior / Late consequences of isolated and non-treated lesions of the posterior cruciate ligament

Vinte e cinco pacientes portadores de lesäo crônica isolada e näo tratada do ligamento cruzado posterior foram avaliados entre um e 30 anos após o trauma inicial. A avaliaçäo compreendeu alteraçöes funcionais, exame clínico e radiográfico. Nesta série, a queixa de dor ocorreu em 100% dos casos, o teste da gaveta posterior a 90- näo foi positivo em todos os pacientes e alteraçöes articulares degenerativas foram detectadas na maioria dos casos