Acute Versus Delayed Surgical Intervention in Multiligament Knee Injuries: A Systematic Review
Background: The optimal timing of surgical intervention for multiligament knee injuries remains controversial. Purpose: To review the clinical and functional outcomes after acute and delayed surgical intervention for multiligament knee injuries. Study Design: Systematic review; Level of evidence, 4....
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Published in | Orthopaedic Journal of Sports Medicine Vol. 9; no. 10; p. 23259671211027855 |
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Main Authors | , , , , , , , |
Format | Book Review Journal Article |
Language | English |
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Los Angeles, CA
SAGE Publications
01.10.2021
Sage Publications Ltd |
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Abstract | Background:
The optimal timing of surgical intervention for multiligament knee injuries remains controversial.
Purpose:
To review the clinical and functional outcomes after acute and delayed surgical intervention for multiligament knee injuries.
Study Design:
Systematic review; Level of evidence, 4.
Methods:
We performed a search of the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to September 2020. Eligible studies reported on knee dislocations, multiligament knee injuries, or bicruciate ligament injuries in adult patients (age, ≥18 years). In addition to comparing outcomes between acute and delayed surgical intervention groups, we conducted 3 subgroup analyses for outcomes within isolated knee injuries, knee injuries with concomitant polytrauma/fractures, and high-level (level 2) studies.
Results:
Included in the analysis were 31 studies, designated as evidence level 2 (n = 3), level 3 (n = 8), and level 4 (n = 20). These studies reported on 2594 multiligament knee injuries sustained by 2585 patients (mean age, 25.1-65.3 years; mean follow-up, 12-157.2 months). At the latest follow-up timepoint, the mean Lysholm (n = 375), International Knee Documentation Committee (IKDC) (n = 286), and Tegner (n = 129) scores for the acute surgical intervention group were 73.60, 67.61, and 5.06, respectively. For the delayed surgical intervention group, the mean Lysholm (n = 196), IKDC (n = 172), and Tegner (n = 74) scores were 85.23, 72.32, and 4.85, respectively. The mean Lysholm (n = 323), IKDC (n = 236), and Tegner (n = 143) scores for our isolated subgroup were 83.7, 74.8, and 5.0, respectively. By comparison, the mean Lysholm (n = 270), IKDC (n = 236), and Tegner (n = 206) scores for the polytrauma/fractures subgroup were 83.3, 64.5, and 5.0, respectively.
Conclusion:
The results of our systematic review did not elucidate whether acute or delayed surgical intervention produced superior clinical and functional outcomes. Although previous evidence has supported acute surgical intervention, future prospective randomized controlled trials and matched cohort studies must be completed to confirm these findings. |
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AbstractList | BACKGROUNDThe optimal timing of surgical intervention for multiligament knee injuries remains controversial. PURPOSETo review the clinical and functional outcomes after acute and delayed surgical intervention for multiligament knee injuries. STUDY DESIGNSystematic review; Level of evidence, 4. METHODSWe performed a search of the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to September 2020. Eligible studies reported on knee dislocations, multiligament knee injuries, or bicruciate ligament injuries in adult patients (age, ≥18 years). In addition to comparing outcomes between acute and delayed surgical intervention groups, we conducted 3 subgroup analyses for outcomes within isolated knee injuries, knee injuries with concomitant polytrauma/fractures, and high-level (level 2) studies. RESULTSIncluded in the analysis were 31 studies, designated as evidence level 2 (n = 3), level 3 (n = 8), and level 4 (n = 20). These studies reported on 2594 multiligament knee injuries sustained by 2585 patients (mean age, 25.1-65.3 years; mean follow-up, 12-157.2 months). At the latest follow-up timepoint, the mean Lysholm (n = 375), International Knee Documentation Committee (IKDC) (n = 286), and Tegner (n = 129) scores for the acute surgical intervention group were 73.60, 67.61, and 5.06, respectively. For the delayed surgical intervention group, the mean Lysholm (n = 196), IKDC (n = 172), and Tegner (n = 74) scores were 85.23, 72.32, and 4.85, respectively. The mean Lysholm (n = 323), IKDC (n = 236), and Tegner (n = 143) scores for our isolated subgroup were 83.7, 74.8, and 5.0, respectively. By comparison, the mean Lysholm (n = 270), IKDC (n = 236), and Tegner (n = 206) scores for the polytrauma/fractures subgroup were 83.3, 64.5, and 5.0, respectively. CONCLUSIONThe results of our systematic review did not elucidate whether acute or delayed surgical intervention produced superior clinical and functional outcomes. Although previous evidence has supported acute surgical intervention, future prospective randomized controlled trials and matched cohort studies must be completed to confirm these findings. Background: The optimal timing of surgical intervention for multiligament knee injuries remains controversial. Purpose: To review the clinical and functional outcomes after acute and delayed surgical intervention for multiligament knee injuries. Study Design: Systematic review; Level of evidence, 4. Methods: We performed a search of the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to September 2020. Eligible studies reported on knee dislocations, multiligament knee injuries, or bicruciate ligament injuries in adult patients (age, ≥18 years). In addition to comparing outcomes between acute and delayed surgical intervention groups, we conducted 3 subgroup analyses for outcomes within isolated knee injuries, knee injuries with concomitant polytrauma/fractures, and high-level (level 2) studies. Results: Included in the analysis were 31 studies, designated as evidence level 2 (n = 3), level 3 (n = 8), and level 4 (n = 20). These studies reported on 2594 multiligament knee injuries sustained by 2585 patients (mean age, 25.1-65.3 years; mean follow-up, 12-157.2 months). At the latest follow-up timepoint, the mean Lysholm (n = 375), International Knee Documentation Committee (IKDC) (n = 286), and Tegner (n = 129) scores for the acute surgical intervention group were 73.60, 67.61, and 5.06, respectively. For the delayed surgical intervention group, the mean Lysholm (n = 196), IKDC (n = 172), and Tegner (n = 74) scores were 85.23, 72.32, and 4.85, respectively. The mean Lysholm (n = 323), IKDC (n = 236), and Tegner (n = 143) scores for our isolated subgroup were 83.7, 74.8, and 5.0, respectively. By comparison, the mean Lysholm (n = 270), IKDC (n = 236), and Tegner (n = 206) scores for the polytrauma/fractures subgroup were 83.3, 64.5, and 5.0, respectively. Conclusion: The results of our systematic review did not elucidate whether acute or delayed surgical intervention produced superior clinical and functional outcomes. Although previous evidence has supported acute surgical intervention, future prospective randomized controlled trials and matched cohort studies must be completed to confirm these findings. The optimal timing of surgical intervention for multiligament knee injuries remains controversial. To review the clinical and functional outcomes after acute and delayed surgical intervention for multiligament knee injuries. Systematic review; Level of evidence, 4. We performed a search of the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to September 2020. Eligible studies reported on knee dislocations, multiligament knee injuries, or bicruciate ligament injuries in adult patients (age, ≥18 years). In addition to comparing outcomes between acute and delayed surgical intervention groups, we conducted 3 subgroup analyses for outcomes within isolated knee injuries, knee injuries with concomitant polytrauma/fractures, and high-level (level 2) studies. Included in the analysis were 31 studies, designated as evidence level 2 (n = 3), level 3 (n = 8), and level 4 (n = 20). These studies reported on 2594 multiligament knee injuries sustained by 2585 patients (mean age, 25.1-65.3 years; mean follow-up, 12-157.2 months). At the latest follow-up timepoint, the mean Lysholm (n = 375), International Knee Documentation Committee (IKDC) (n = 286), and Tegner (n = 129) scores for the acute surgical intervention group were 73.60, 67.61, and 5.06, respectively. For the delayed surgical intervention group, the mean Lysholm (n = 196), IKDC (n = 172), and Tegner (n = 74) scores were 85.23, 72.32, and 4.85, respectively. The mean Lysholm (n = 323), IKDC (n = 236), and Tegner (n = 143) scores for our isolated subgroup were 83.7, 74.8, and 5.0, respectively. By comparison, the mean Lysholm (n = 270), IKDC (n = 236), and Tegner (n = 206) scores for the polytrauma/fractures subgroup were 83.3, 64.5, and 5.0, respectively. The results of our systematic review did not elucidate whether acute or delayed surgical intervention produced superior clinical and functional outcomes. Although previous evidence has supported acute surgical intervention, future prospective randomized controlled trials and matched cohort studies must be completed to confirm these findings. Background: The optimal timing of surgical intervention for multiligament knee injuries remains controversial. Purpose: To review the clinical and functional outcomes after acute and delayed surgical intervention for multiligament knee injuries. Study Design: Systematic review; Level of evidence, 4. Methods: We performed a search of the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to September 2020. Eligible studies reported on knee dislocations, multiligament knee injuries, or bicruciate ligament injuries in adult patients (age, ≥18 years). In addition to comparing outcomes between acute and delayed surgical intervention groups, we conducted 3 subgroup analyses for outcomes within isolated knee injuries, knee injuries with concomitant polytrauma/fractures, and high-level (level 2) studies. Results: Included in the analysis were 31 studies, designated as evidence level 2 (n = 3), level 3 (n = 8), and level 4 (n = 20). These studies reported on 2594 multiligament knee injuries sustained by 2585 patients (mean age, 25.1-65.3 years; mean follow-up, 12-157.2 months). At the latest follow-up timepoint, the mean Lysholm (n = 375), International Knee Documentation Committee (IKDC) (n = 286), and Tegner (n = 129) scores for the acute surgical intervention group were 73.60, 67.61, and 5.06, respectively. For the delayed surgical intervention group, the mean Lysholm (n = 196), IKDC (n = 172), and Tegner (n = 74) scores were 85.23, 72.32, and 4.85, respectively. The mean Lysholm (n = 323), IKDC (n = 236), and Tegner (n = 143) scores for our isolated subgroup were 83.7, 74.8, and 5.0, respectively. By comparison, the mean Lysholm (n = 270), IKDC (n = 236), and Tegner (n = 206) scores for the polytrauma/fractures subgroup were 83.3, 64.5, and 5.0, respectively. Conclusion: The results of our systematic review did not elucidate whether acute or delayed surgical intervention produced superior clinical and functional outcomes. Although previous evidence has supported acute surgical intervention, future prospective randomized controlled trials and matched cohort studies must be completed to confirm these findings. |
Author | Marder, Ryan S. Nguyen, Frank Zikria, Bashir A. Pincay, Jorge I. Poonawala, Husain Naziri, Qais Persaud, Christine S. Cleary, Patrick F. |
AuthorAffiliation | Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Investigation performed at State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA |
AuthorAffiliation_xml | – name: Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA – name: Department of Orthopaedic Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar – name: Investigation performed at State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA |
Author_xml | – sequence: 1 givenname: Ryan S. surname: Marder fullname: Marder, Ryan S. – sequence: 2 givenname: Husain surname: Poonawala fullname: Poonawala, Husain – sequence: 3 givenname: Jorge I. surname: Pincay fullname: Pincay, Jorge I. – sequence: 4 givenname: Frank surname: Nguyen fullname: Nguyen, Frank – sequence: 5 givenname: Patrick F. surname: Cleary fullname: Cleary, Patrick F. – sequence: 6 givenname: Christine S. surname: Persaud fullname: Persaud, Christine S. – sequence: 7 givenname: Qais surname: Naziri fullname: Naziri, Qais email: qnaziri@gmail.com – sequence: 8 givenname: Bashir A. surname: Zikria fullname: Zikria, Bashir A. |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34671686$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1007_s00167_022_07064_6 crossref_primary_10_1007_s00402_023_04884_0 crossref_primary_10_1007_s00590_023_03781_x crossref_primary_10_1002_ksa_12332 crossref_primary_10_1007_s00167_023_07514_9 crossref_primary_10_1016_j_jcjp_2023_100143 crossref_primary_10_1007_s00402_023_04863_5 crossref_primary_10_1177_23259671231223188 crossref_primary_10_35366_111160 crossref_primary_10_4103_jbjd_jbjd_40_23 crossref_primary_10_1177_03635465241252440 crossref_primary_10_2106_JBJS_20_02051 crossref_primary_10_5435_JAAOS_D_22_00339 crossref_primary_10_1016_j_jcot_2022_101807 crossref_primary_10_7759_cureus_34219 |
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Keywords | surgical timing knee dislocations multiligament knee injuries surgical intervention |
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SecondaryResourceType | review_article |
Snippet | Background:
The optimal timing of surgical intervention for multiligament knee injuries remains controversial.
Purpose:
To review the clinical and functional... The optimal timing of surgical intervention for multiligament knee injuries remains controversial. To review the clinical and functional outcomes after acute... Background: The optimal timing of surgical intervention for multiligament knee injuries remains controversial. Purpose: To review the clinical and functional... BACKGROUNDThe optimal timing of surgical intervention for multiligament knee injuries remains controversial. PURPOSETo review the clinical and functional... |
SourceID | pubmedcentral proquest crossref pubmed sage |
SourceType | Open Access Repository Aggregation Database Index Database Publisher |
StartPage | 23259671211027855 |
SubjectTerms | Joint and ligament injuries Knee Orthopedics Sports injuries Sports medicine Systematic review |
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Title | Acute Versus Delayed Surgical Intervention in Multiligament Knee Injuries: A Systematic Review |
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