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By Will Boggs, MD
NEW YORK, Mar 27 (Reuters Health) - A special knee-joint support, called the compass knee hinge, can speed healing after surgical repair of a dislocated knee, according to a recent report.
Motor vehicle accidents, sports injuries and other trauma can knock the knee out of joint, and these dislocations can tear the ligaments that connect the leg bones as well as injure the blood vessels and nerves that pass near the joint.
Surgery is used to rebuild the injured tissues, according to Dr. James Stannard, an orthopedic trauma surgeon at the University of Alabama at Birmingham. But even after surgery has repaired the ligaments, the joint must be protected against stresses that can keep the tissues from healing properly and lead to long-term disability, Stannard told Reuters Health in an interview.
Stannard and his associates recently completed a study of the compass knee hinge (CKH), manufactured by Smith & Nephew Orthopedics in Memphis, Tennessee. The CKH is designed to keep the knee from twisting or bending too much in any direction. This adjustable device is placed outside the skin but is attached to the bones above and below the front of the knee joint by pins that pass through the skin. The hinge looks daunting but isn't especially uncomfortable, Stannard said.
In the study of 40 patients recovering from ligament reconstruction, those with the hinge fared better after surgery than those without the hinge. According to the results presented at the annual meeting of the American Academy of Orthopedic Surgeons, the ligament repair procedures failed in only 7% of the CKH patients, compared with 29% of the non-CKH patients.
Stannard sees this as a big improvement over the braces usually worn after such surgery. "There is (currently) not a way to get aggressive motion and therapy without tearing the reconstructed ligaments," he explained.
Still, he believes formal studies are needed to prove his theory, so he is currently leading another study in which some patients get the CKH and some do not. He expects to be able to reach a conclusion about the benefits of the hinge in the next year or two.
At a cost of $3,500 to $4,000, Stannard said, the CKH is not cheap. "But if it was my own knee," he confessed, "I'd want the hinge."
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