Ms. Shapiro et El. Freedman, ALLOGRAFT RECONSTRUCTION OF THE ANTERIOR AND POSTERIOR CRUCIATE LIGAMENTS AFTER TRAUMATIC KNEE DISLOCATION, American journal of sports medicine, 23(5), 1995, pp. 580-587
Seven patients (average age, 26.3 years) with traumatic knee dislocati
ons were retrospectively evaluated more than 2 years (average, 51 mont
hs) after having fresh-frozen allograft anterior and posterior cruciat
e ligament reconstructions. Ail patients were treated consecutively at
an average of 9.6 days after injury. Two patients had arterial injuri
es and three patients had or developed common peroneal nerve palsy. Fi
ve patients had 20 additional injuries. All patients were enlisted in
an early, aggressive physical therapy regimen with early protected wei
ghtbearing. Four patients required a manipulation under anesthesia for
arthrofibrosis at an average of 16.8 weeks postoperatively (range, 6
to 33 weeks). At followup, only one patient had significant pain, thre
e patients had rare or occasional giving way, and all seven were able
to return to school or to the workplace. The functional grading was ex
cellent in three patients, good in th ree patients, and fair in one pa
tient. No patient had a significant flexion contracture; the average f
lexion are was 118 degrees (range, 105 degrees to 135 degrees). Knee d
islocation is a very traumatic injury, often resulting in a painful, d
ysfunctional knee. Anterior and posterior cruciate ligament reconstruc
tions in young, active patients can minimize pain and optimize functio
nal outcome. Arthrofibrosis is a common occurrence in these patients,
and manipulation under anesthesia is frequently required.