Clinical Outcomes Of Multi-ligament Knee Injuries In Assiut University Hospitals

Knee Injuries Clinical Trial

Official title:

Clinical Outcomes Of Multi-ligament Knee Injuries In Assiut University Hospitals

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT04709133
• Other study ID #: AssiutUMAAFMD
• Status: Not yet recruiting
• Phase: N/A
• Start date: January 2021
• Est. completion date: December 2023

Study information

• Verified date: January 2021
• Source: Assiut University
• Contact: mohammed Abdelnasser, assistant lecturer
• Phone: 01060643674
• Email: mohammedabdelnasserdd1991[@]gmail.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Multi-ligament knee injuries (MLKI) are devastating injuries. They are defined as injuries to at least two of the four major ligaments in the knee: anterior cruciate ligament, posterior cruciate ligament, lateral collateral ligament (and posterolateral corner) and medial collateral ligament (and posteromedial corner). These injuries are commonly classified using the Schenck classification system. The incidence of these injuries has been reported to be around 0.02-0.20% of all orthopaedic injuries. However, this is likely to be an underestimation due to spontaneous knee reduction and missed injuries. The immediate management of these injuries is crucial in identifying and treating any vascular and nerve injury. The literature has shown poor outcome and residual instability in those who were treated non-operatively. However, the optimal surgical treatment for these injuries is not known, with differences in opinion amongst treating clinicians. There are controversies in the timing of surgery (early versus delayed), single-staged or two-staged procedures and whether the damaged ligaments should be repaired or reconstructed

Description:

Approximately 50% of all knee dislocations reduce spontaneously before the physician's arrival. Thus, high suspicion must be held, and literally every MLKI must be treated immediately as a true knee dislocation until proven otherwise. Failing to recognize the whole injury pattern around the knee can lead to disastrous consequences. Thus, an initial interdisciplinary systematic approach obtains top priority. Even though diagnostic image instruments become more and more reliable, physical examination still remains a fundamental element in any accurate assessment of knee dislocation. Several authors describe their own experiences and related treatment strategies of knee dislocation. But although a large number of studies about knee dislocation and MLKI do exist in medical databases, the complexity of this injury, the inhomogeneity of literature, and the persevering controversies in their treatment still make it difficult to draw reliable general conclusions.

Although important advances have been made in knee arthroscopy, ligament reconstruction and patient management, recommendations are not always applicable in settings with limited resources available. Challenges encountered in these situations include long delays to presentation, as well as the lack of sufficient access to operating room time, arthroscopic equipment, newer fixation devices, and allografts. Patients are often uninsured; work informally as manual laborers and their access to physiotherapy is very limited.

The purpose of this study is to analyse our institution's experience with multi-ligament knee injuries via the following items prevalence, detailed initial management at emergency department, types of these injuries, rationale of definitive treatment, rehabilitation protocol, postoperative complications and functional outcomes.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 4
• Est. completion date: December 2023
• Est. primary completion date: December 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 55 Years

Eligibility

Inclusion Criteria:

• • Patients presented to emergency department of Assiut University Hospital with knee dislocation.

• Patients presented to outpatient sport clinics of Assiut University Hospital with two or more ligamentous knee injury.

• Age from 18-55 years old.

• Uninjured contralateral knee.

• Informed consent obtained by the patient.

Exclusion Criteria:

• • Advanced knee osteoarthritis.

• Current ipsilateral knee septic arthritis.

• Patient with current psychological disease.

• Patient with medically managed severe systemic disease.

• Recent history of substance abuse (i.e. recreational drugs, alcohol) that would preclude reliable assessment.

• Prisoner.

Related Conditions & MeSH terms

• Knee Injuries
• Wounds and Injuries

Intervention

Procedure:
• multi-ligament knee surgery
a chart review will be performed to identify patients who underwent surgical treatment for multi-ligamentous knee injuries at Assiut University Hospital performed by one of sports medicine orthopaedic surgeons at Assiut arthroscopy and sport unit.

Locations

Country	Name	City	State
Egypt	Faculty of medicine Assiut University	Assiut

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

Country where clinical trial is conducted

Egypt, 

References & Publications (1)

Fanelli GC, Fanelli DG. Multiple Ligament Knee Injuries. J Knee Surg. 2018 May;31(5):399-409. doi: 10.1055/s-0038-1636910. Epub 2018 Mar 13. Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The arabic translated and validated Lysholm Knee Score	a chart review will be performed to identify patients who underwent surgical treatment for multiligamentous knee injuries at Assiut University Hospital performed by one of sports medicine orthopaedic surgeons at Assiut arthroscopy and sport unit.	6 months