ArticleJournal of orthopaedic case reports2026
Knee Joint Dislocation in a Difficult, Low-Resource Himalayan Setting: A Longitudinal Functional Outcome Study.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Knee joint dislocation is a rare and limb-threatening injury, which is often missed due to its association with other life-threatening injuries and is particularly challenging to manage in a low-resource setting. Our study is a longitudinal observational study evaluating the functional recovery trends following knee joint dislocation in a tertiary care hospital in the Himalayan Region of India. Materials and Methods: This was a longitudinal study conducted from September 2022 to June 2024. It included a total of 28 patients who presented to the hospital with a dislocated knee joint, of which half were managed surgically, while the other half were managed conservatively post-reduction. Functional outcomes were assessed using the Lysholm Knee Scoring Scale, International Knee Documentation Committee (IKDC) subjective score, and EQ-5D-5L at 6 weeks, 3 months, and 6 months. Statistical analyses were performed using the Statistical Package for the Social Sciences version 29. Results: Of the 28 patients (22 males and 6 females; mean age 39.3 ± 13.4 years), exactly half were managed conservatively, and the other 14 operatively. Kennedy type A (75%), and Schenck KD I (36%) injuries predominated. Functional scores improved gradually across time points. At 6 months, mean Lysholm scores (conservative 61.7 ± 11.3 versus operative 64.3 ± 10.8, P = 0.53, Cohen's d = -0.24) and IKDC scores (61.2 ± 3.3 versus 54.1 ± 9.4, P = 0.63, d = 0.19) were statistically comparable. EQ-5D-5L indices (0.75 ± 0.09 versus 0.78 ± 0.08, P = 0.40) paralleled these findings. Repeated-measures analysis of variance revealed significant within-group improvement (F = 12.4, P < 0.001) but no group-time interaction (P = 0.72). Sensitivity analysis excluding vascular cases confirmed robustness (adjusted P = 0.61). Conclusion: Both management modalities yielded equivalent short-term recovery. Conservative management, when feasible and with preserved vascular integrity, can achieve satisfactory functional outcomes along with reduced cost (approximately 40% lower than operative management) in low- and middle-income resource settings such as the Himalayan region. Enhanced rehabilitation access remains essential for recovery and better functional outcomes. Long-term, multicentric research is needed to provide more robust data on this topic.
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