A knee dislocation is an unusual and extremely serious injury and is defined as complete displacement of the tibia with respect to the femur, usually with disruption of 3 or more of the stabilizing ligaments. When the knee dislocates, there is often significant damage to the soft-tissues envelope surrounding the joint, including adjacent neurovascular structures. Not surprisingly, this injury is a profoundly debilitating, life-altering event, with the potential to necessitate career change in athletes and laborers alike. Current evidence indicates that operative management for these injuries is more effective at returning patients to pre-morbid range of motion (ROM) and activity than conservative management. Post operative rehabilitation programs for these patients must balance the need for stability of their surgical repair and knee ROM and functionality. Experimental data suggests that post-operative immobilization offers greater protection of the surgical reconstruction, whereas immediate, aggressive physiotherapy may be more effective at preventing arthrofibrosis stiffness. The investigators are proposing a randomized clinical trial comparing early physiotherapy (day one post op) versus immobilization for three weeks then initiation of physiotherapy. The physiotherapy progams will be identicalbe in all aspects except for progam initiation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
38
Physiotherapy starting at one day post op
St. Michael's Hospital
Toronto, Ontario, Canada
Need for knee manipulation at or within 6months of initial surgery.
Manipulation includes: 1. Knee manipulation under anesthesia 2. Arthroscopic debridement of arthrofibrosis 3. Open debridement of arthrofibrosis
Time frame: 6 months
Knee Range of Motion
Passive Range of Motion
Time frame: 6 months
Knee stability
Clinical exam of ligament grading
Time frame: 6 months
Patient Reported Outcome
Multi-Ligament Quality of Life Questionnaire
Time frame: 6 months
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