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MRI diagnosis in multiligamentous injuries of knee with associated dislocations and neurovasacular sequelae: a retrospective analysis of injury patterns

Abstract

Background

Simultaneous injury of two or more knee ligaments with concurrent tears involving the anterior cruciate and medial collateral ligaments is considered to be associated with femorotibial knee dislocations (KD). The purpose of this study is to characterize multiligamentous knee injury patterns associated with dislocations on MRI and to describe the incidence of their sequelae such as tibial plateau fractures, peroneal nerve injuries, and posterolateral corner (PLC) injuries.

Participants and methods

After obtaining institutional ethical committee approval, we retrospectively identified 108 multiligamentous knee injuries in 100 patients who met with trauma and were treated at our tertiary care center between April 2014 and December 2018. Descriptive statistics were reported using numbers and percentages for categorical variables in cases of multiligamentous injuries, ipsilateral tibial plateau fractures, ipsilateral femoral fractures, peroneal nerve injury, arterial injury, compartment syndrome, and PLC injuries.

Results

The most common (39.8%) injury pattern was a combined disruption of the anterior cruciate ligament, posterior cruciate ligament, and PLC. Schenck KD III-M was the most common injury type in KD, constituting 16.7%. Medial-sided injuries were the most common injury patterns seen with KD. There was a significant risk of peroneal nerve injury with lateral-sided injuries.

Conclusion

KD, though rare, may have devastating clinical sequelae such as compartment syndrome if not recognized and treated. Therefore, it is necessary to recognize imaging findings of femorotibial joint dislocations and associated injuries to the adjacent neurovascular bundles.

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Correspondence to Reddy Ravikanth MD.

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Ravikanth, R., Abraham, M.J., Pilar, A. et al. MRI diagnosis in multiligamentous injuries of knee with associated dislocations and neurovasacular sequelae: a retrospective analysis of injury patterns. Egypt Rheumatol Rehabil 46, 278–284 (2019). https://doi.org/10.4103/err.err_22_19

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