Dislocation knee treatment in Ahmedabad , INDIA

Dislocation knee ,Ahmedabad  Straight leg rase , Ahmedabad, Knee surgery  Allo graft, Ahmedabad.  Knee arthrplasty, Ligament reconstruction  Ligament reconstruction surgery, arthroscopy surgery  LCL reconstruction  IITV knee x ray post op , B-PT-B graft  Knee surgery, Ahmedabad

Multiple knee ligaments injury (ACL injury, PCL injury, MCL injury &/or LCL injury) is common after knee dislocation ( KD3 or KD4). A 53 yrs., active obese female came to Aash Arthroscopy center in May 2016 with 20 days old UNREDUCED LOCKED KNEE DISLOCATION of left knee due to fall at home. She was brought in a wheel chair as she could not walk. Inspite of such devastating knee injury, blood & nerve supply to the limb was normal. Her knee was unstable for last 2 yrs because of multiple ligament’s injury but she was managing with a knee brace and physiotherapy. According to her she was able to walk 2-3 kms without pain with a knee brace.

 

Knee MRI not only showed injury to all ligaments but also to medial & lateral meniscus. Unreduced anterior knee dislocation was seen on X-ray. MR angiography of her affected limb showed adequate blood circulation.
Open reduction of dislocation was performed. Due to multiple episodes of falls, all the tissues were very lax. To stabilize the knee, it was decided to perform simultaneous Posterior Cruciate ligament (PCL), Lateral collateral ligament (LCL) & Popliteus reconstruction. PCL reconstruction & Lateral ligament reconstruction was done by using Bone –Patella Tendon- Bone graft (BPTB) graft, Semitendnosus & Gracilis graft respectively. These autografts were harvested from opp. Limb as allograft is not available in India. ACL reconstruction was deffered to another time.
To protect the reconstructed ligaments & to prevent redislocation, an external fixator was applied spanning the knee. Additional stability was also given by a plaster SLAB. Post operative recovery was uneventful. Repeated monitoring was done to ascertain that patient never had vascular or neurological injury. Patient was able to do straight leg raising (SLR) exercise of operated knee from day 4. Othere knee’s functions became normal on 2nd day.
Locked anterior knee dislocation presenting after 20 days without neurological & vascular problem is very rare. Usually such dislocation  is treated as a surgical emergency. To reduce it & to retain it in a reduced state, require lots of efforts & expertise.
We hope that the patient will have functional range of movements in next few months.

 

                                                              After 3 weeks (June 2016)

Dislocation knee  Dislocation knee , Ahmedabad   Ahmedabad

IT was very encouraging to see a happy patient 3 weeks after the surgery. Image 1 shows operated limb. Image 2 shows recovery of right limb from which the grafts were harvested. Patient was easily able to do straight leg raising (SLR) with external fixator 30 times a day. X-ray after 3 weeks showed reduced joint and very nice alignment. Patient was advised to continue physiotherapy under care of a physiotherapist. External fixator was removed

                                                   After 9 months (January 2017)

ACL, PCL reconstruction,Arthroscopy knee surgery                                 Dislocation knee,Knee ligament injury

After 9 months of PCL & PLC reconstruction, patient has full extension & bilateral equal flexion of knees. She is not experiencing any pain in daily activties. She is walking unaided in the house wihtout any knee support even after not having ACL.

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