Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Timing of surgery for knee injuries may not affect outcomes

02.12.2009
Multiple-ligament knee injuries resulting from traumatic knee dislocations – such as high impact car accidents or certain sports are uncommon, and the optimal timing of surgical repair or reconstruction has not been definitively established.

According to a new study published in the December 2009 issue of The Journal of Bone and Joint Surgery (JBJS), patients who undergo surgery more than three weeks after a multiple ligament knee injury (called chronic intervention treatment) may have comparable outcomes to those who undergo surgery within three weeks of injury (called acute intervention treatment) with regard to knee stability.

Additionally, researchers found that early mobility is associated with better outcomes than immobilization in those patients who are treated within that three week time period.

"After a review of the available literature, we found that chronic intervention provides results that are at least as good as acute intervention, despite some recent studies showing that acute intervention may be better," said lead author of the study William R. Mook, MD, who conducted the study with colleagues from the Department of Orthopaedic Surgery at the University of Virginia in Charlottesville.

Dr. Mook and his colleagues surveyed 24 retrospective studies that included 396 knees treated surgically for the most severe multiple-ligament knee injuries. Patients were managed either acutely, chronically, or with a combination of both interventions, which is called staged treatment. The researchers also studied whether the patient's leg should or should not be mobile or immobilized after surgery.

The study found that:

patients receiving acute intervention had less stable knees and were not able to bend their knees as far as those who were treated with chronic intervention; and

patients who underwent staged procedures (treatment from both the acute and chronic intervention stages) reported better outcomes than those treated just early or late.

"The reasons for this are not clear. The patient population is heterogeneous, and surgery can be delayed for a variety of reasons. It is difficult to tell which procedures were delayed intentionally and which were delayed due to other medical reasons occurring as a result of their initial injury," Dr. Mook said.

This literature review suggests the following:

Surgical reconstructions within three weeks of the injury and those performed later provide comparable knee stability.
In patients treated within three weeks of injury, early mobility (compared with immobilization) is associated with better outcomes. However, early surgery is highly associated with range-of-motion limitations.
Patients reported better outcomes and fewer range-of-motion limitations with a combination of acute and chronic procedures. However, additional treatment for joint stiffness may be required in these patients.

In patients treated within three weeks of their injury, more aggressive rehabilitation may prevent the need for additional treatment for joint stiffness.

Previous studies have indicated that early treatment provides better outcomes, but that may not be the case. "Although recent evidence suggests that acute intervention is superior to chronic interventions in all outcomes, we found that chronic intervention may provide knees with equal stability as those managed acutely," Dr. Mook concluded.

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Kristina Findlay | EurekAlert!
Further information:
http://www.aaos.org

More articles from Health and Medicine:

nachricht Using fragment-based approaches to discover new antibiotics
21.06.2018 | SLAS (Society for Laboratory Automation and Screening)

nachricht Scientists learn more about how gene linked to autism affects brain
19.06.2018 | Cincinnati Children's Hospital Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Temperature-controlled fiber-optic light source with liquid core

In a recent publication in the renowned journal Optica, scientists of Leibniz-Institute of Photonic Technology (Leibniz IPHT) in Jena showed that they can accurately control the optical properties of liquid-core fiber lasers and therefore their spectral band width by temperature and pressure tuning.

Already last year, the researchers provided experimental proof of a new dynamic of hybrid solitons– temporally and spectrally stationary light waves resulting...

Im Focus: Overdosing on Calcium

Nano crystals impact stem cell fate during bone formation

Scientists from the University of Freiburg and the University of Basel identified a master regulator for bone regeneration. Prasad Shastri, Professor of...

Im Focus: AchemAsia 2019 will take place in Shanghai

Moving into its fourth decade, AchemAsia is setting out for new horizons: The International Expo and Innovation Forum for Sustainable Chemical Production will take place from 21-23 May 2019 in Shanghai, China. With an updated event profile, the eleventh edition focusses on topics that are especially relevant for the Chinese process industry, putting a strong emphasis on sustainability and innovation.

Founded in 1989 as a spin-off of ACHEMA to cater to the needs of China’s then developing industry, AchemAsia has since grown into a platform where the latest...

Im Focus: First real-time test of Li-Fi utilization for the industrial Internet of Things

The BMBF-funded OWICELLS project was successfully completed with a final presentation at the BMW plant in Munich. The presentation demonstrated a Li-Fi communication with a mobile robot, while the robot carried out usual production processes (welding, moving and testing parts) in a 5x5m² production cell. The robust, optical wireless transmission is based on spatial diversity; in other words, data is sent and received simultaneously by several LEDs and several photodiodes. The system can transmit data at more than 100 Mbit/s and five milliseconds latency.

Modern production technologies in the automobile industry must become more flexible in order to fulfil individual customer requirements.

Im Focus: Sharp images with flexible fibers

An international team of scientists has discovered a new way to transfer image information through multimodal fibers with almost no distortion - even if the fiber is bent. The results of the study, to which scientist from the Leibniz-Institute of Photonic Technology Jena (Leibniz IPHT) contributed, were published on 6thJune in the highly-cited journal Physical Review Letters.

Endoscopes allow doctors to see into a patient’s body like through a keyhole. Typically, the images are transmitted via a bundle of several hundreds of optical...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Munich conference on asteroid detection, tracking and defense

13.06.2018 | Event News

2nd International Baltic Earth Conference in Denmark: “The Baltic Sea region in Transition”

08.06.2018 | Event News

ISEKI_Food 2018: Conference with Holistic View of Food Production

05.06.2018 | Event News

 
Latest News

New cellular pathway helps explain how inflammation leads to artery disease

22.06.2018 | Life Sciences

When fluid flows almost as fast as light -- with quantum rotation

22.06.2018 | Physics and Astronomy

Exposure to fracking chemicals and wastewater spurs fat cell development

22.06.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>