caa a22 4500 605458308 CHVBK 20210128100228.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00167-015-3719-0 doi (NATIONALLICENCE)springer-10.1007/s00167-015-3719-0 External fixator for treatment of the sub-acute and chronic multi-ligament-injured knee [Elektronische Daten] [Fabio Angelini, Camilo Helito, Marcelo Bonadio, Tales Guimarães, Ronald Barreto, José Pécora, Gilberto Camanho, Roberto da Mota e Albuquerque] Purpose: To assess whether the use of an articulated external fixator provides improvements in the mobility, stability and subjective function of patients undergoing ligament reconstruction. Methods: Thirty-three patients with sub-acute and chronic knee dislocation were subjected to multi-ligament reconstruction surgery. These patients were randomly allocated to two groups for immobilization after reconstruction: group 0—control (18 patients), with rigid knee bracing, and group 1—articulated external fixator (15 patients). The stability of the reconstructed ligaments was assessed after at least 14months (26.6-month average) postoperatively by physical examination. Deficit of extension and flexion was measured in relation to the unaffected contralateral knee, and the Lysholm knee scoring scale questionnaire was applied. Results: There was no difference in the assessment of joint stability between the groups. In group 1, patients showed less flexion deficit (4.8°±5.4° vs. 18.2°±14.8°, p<0.05), and the percentage of patients with a flexion deficit of 5° or less were higher compared with group 0 (64 vs. 18%, p<0.05). There was no difference between groups in relation to extension loss. Group 1 also presented better Lysholm scores, with 73% of patients rated as excellent or good compared with 35% in group 0 (p<0.05). Conclusions: Compared with the control rehabilitation protocol with rigid knee bracing in extension, the use of an articulated external fixator in the treatment of chronic multi-ligament-injured knees provided the same ligament stability, better final range of motion and improved Lysholm score. Patients presenting with chronic multi-ligament instability should be considered for articulated external fixation to supplement reconstruction procedures. Level of evidence: Randomized controlled trial, Level I. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 Knee dislocation/surgery nationallicence Knee dislocation/rehabilitation nationallicence Posterior cruciate ligament/injury nationallicence Posterior cruciate ligament/surgery nationallicence External fixators nationallicence Restraints nationallicence Angelini Fabio Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut Helito Camilo Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut Bonadio Marcelo Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut Guimarães Tales Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut Barreto Ronald Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut Pécora José Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut Camanho Gilberto Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut da Mota e Albuquerque Roberto Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 3012-3018 0942-2056 23:10<3012 2015 23 167 https://doi.org/10.1007/s00167-015-3719-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-015-3719-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Angelini Fabio Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Helito Camilo Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Bonadio Marcelo Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Guimarães Tales Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Barreto Ronald Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Pécora José Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- Camanho Gilberto Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 700 1- da Mota e Albuquerque Roberto Knee Surgery Division, Department of Orthopedics and Traumatology, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 333, CEP 05403-010, Cerqueira Cesar, São Paulo, SP, Brazil aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/10(2015-10-01), 3012-3018 0942-2056 23:10<3012 2015 23 167