The diagnosis of fresh combination injuries of the knee joint is difficult. It is under all circumstances mandatory, occasionally by employing general anesthesia, to establish a diagnosis and the extend of the injury to decide on a conservative or surgical approach. Partial ruptures of the capsule and ligaments may be treated conservatively, complete ruptures are a surgical must.
Between 1963 and 1974 we operated on 35 knees in 34 patients artier a fresh combination injury of the knee joint. 14 patients (15 knees) could be followed between 2 and 10 years postoperatively. All patients were satisfied with the result and were participating in sports. The objective results were excellent in 2, good in 12 and sufficient in 1. Knee joint stability could be reestablished in all knees.
Follow-ups of a similar group of 14 patients after reconstructive treatment of an old "unhappy triad" showed considerably poorer results both subjectively and objectively. We conclude that fresh complete ruptures of the ligamentous and capsular structures of the knee joint have to be surgically repaired immediately to prevent permanent damage.
Zusammenlassung. Die Diagnostik der frisehen Kombinationsverletzung des Kniegelenkes wirft Probleme auf. Trotzdem muB unter Einsatz aller verffigbaren Mittel, auch der Allgemeinnarkose, eine sichere Aussage fiber das Ver-letzungsausmaB erreieht werden, um die Indikation zur konservativen oder operativen Therapie abzugrenzen. Kapselbandteilrupturen k6nnen konservativ, komplette Rupturen miissen operativ versorgt werden.
Im Zeitraum yon 1963 bis 1974 wurden an unserem Hause 35 Kniegelenke bei 34 Patienten wegen einer frischen Kombinationsverletzung operativ versorgt. 14 Patienten (15 Kniegelenke) konnten 2 bis I0 Jahre postoperativ nachuntersucht werden. Alle Patienten waren mit dem Operationsergebnis zufrieden und sportlich wieder aktiv. Das objektive Ergebnis war bei 2 Knie-