Knee dislocations are a rare but serious cause of trauma. The aim of this study was to establish current demographics and injury patterns/associations in multi-ligament (MLI) knee injuries in the United Kingdom. A National survey was sent out to trauma & orthopaedic trainees using the British Orthopaedic Trainees Association sources in 2018. Contributors were asked to retrospectively collect a data for a minimum of 5 cases of knee dislocation, or multi-ligament knee injury, between January 2014 and December 2016. Data was collected regarding injury patterns and surgical reconstructions. 73 cases were available for analysis across 11 acute care NHS Trusts. 77% were male. Mean age was 31.9 (SD 12.4; range 16–69). Mean Body Mass Index (BMI) was 28.3 (SD 7.0; range 19–52). Early (<3 weeks) reconstruction was performed in 53% with 9 (23%) patients under-going procedures for arthrofibrosis. Late (>12 weeks) reconstruction took place in 37% with one (3.7%) patient under-going arthroscopic arthrolysis. 4% had delayed surgery (3–12 weeks) and 5% had early intervention with delayed ACL reconstruction. For injuries involving 3 or more ligament injuries graft choices were ipsilateral hamstring (38%), bone-patella tendon-bone (20%), allograft (20%), contralateral hamstring (17%) and synthetic grafts in 18%. Multi-ligament knee injuries are increasingly being managed early with definitive reconstructions. This is despite significant risk of arthrofibrosis with early surgery. Ipsilateral and contralateral hamstring grafts make up the bulk of graft choice however allograft (20%) and synthetic grafts (18%) remain popular.
With associated snow sports injury risks being well documented, the scope for preventative medicine is clear. This article focuses on potential precautions taken by skiers/snowboarders and how they vary between different snow sport groups. A total of 181 randomly selected individuals from the Whistler/Blackcomb Medical Centre, Canada, took part in this questionnaire-based cohort study, examining snow sports activity, preventive measures, and protective equipment use. Most individuals were ski area residents of advanced expertise, with 50% having had a previous snow-riding injury. The most commonly reported significant ski injury was anterior cruciate ligament (ACL) rupture, while in snowboarders, it was wrist fracture. Skiers were more likely to improve fitness levels before going onto the slopes, whereas crossover riders (both skiing and snowboarding) were more likely to take lessons. Most individuals used eye and sun protection and had adequately warm clothing. Beyond basic precautions, protective equipment and preventive measures are used infrequently. It is suggested that by increasing awareness and use of such equipment, injury rates may be reduced.