{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:07Z","timestamp":1787755807266,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>Salvage of traumatic extruded open knee joints is very rare. We present a 32-year-old man who sustained a Gustilo 3b open floating knee injury with an extruded knee joint following a road traffic accident. Thorough wound debridement with reimplantation of the extruded knee joint was performed. Skeletal stabilization by external fixation and early free flap cover were performed. Later, definitive fixation with bone grafting of the distal femur and proximal tibia was performed. All fractures united and achieved passive knee flexion of 90\u00b0 and Lower Extremity Functional Scale of 54.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>An extruded knee joint following major open injury can be salvaged using multidisciplinary team approach and achieve satisfactory outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:underline>V<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Clinical Care:<\/jats:title>\n                    <jats:p>\n                      <jats:underline>Level I<\/jats:underline>\n                      Tertiary trauma center.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.25.00169","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T18:01:20Z","timestamp":1756404080000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Successful Salvage of an Extruded Knee Joint in an Open Injury: An Integrated Team Approach"],"prefix":"10.2106","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5007-3644","authenticated-orcid":false,"given":"Agraharam","family":"Devendra","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5392-6056","authenticated-orcid":false,"given":"Asif","family":"Imran","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purnaganapathi Sundaram","family":"Velmurugesan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0436-2100","authenticated-orcid":false,"given":"Sanjai","family":"Ramkumar","sequence":"additional","affiliation":[{"name":"Department of Plastic, Hand and Reconstructive Surgery, Ganga Medical Centre & Hospitals, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1295-136X","authenticated-orcid":false,"given":"Jayaramaraju","family":"Dheenadhayalan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-006X","authenticated-orcid":false,"given":"Shanmuganathan","family":"Rajasekaran","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7]]},"reference":[{"key":"bib1-20250828","doi-asserted-by":"crossref","first-page":"1333575","DOI":"10.3389\/fped.2024.1333575","article-title":"Successful reimplantation of extruded bone segment in lower limb open fractures: case report and literature review","volume":"12","author":"Hu","year":"2024","journal-title":"Front Pediatr."},{"issue":"1","key":"bib2-20250828","first-page":"10","article-title":"Initial assessment, debridement, and decision making in the salvage of severely injured lower extremity","volume":"52","author":"Sabapathy","journal-title":"Indian J Plast Surg."},{"issue":"1","key":"bib3-20250828","doi-asserted-by":"crossref","first-page":"3","DOI":"10.2106\/00004623-200101000-00002","article-title":"A prospective evaluation of the clinical utility of the lower-extremity injury-severity scores","volume":"83","author":"Bosse","year":"2001","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib4-20250828","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1302\/0301-620X.105B1.BJJ-2022-0934.R1","article-title":"Clinical effectiveness of the ganga hospital open injury severity score for limb salvage versus amputation in patients with complex limb injuries: a systematic review and meta-analysis","volume":"105-B","author":"Ndlovu","year":"2023","journal-title":"Bone Joint J."},{"issue":"10","key":"bib5-20250828","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1302\/0301-620X.88B10.17631","article-title":"A score for predicting salvage and outcome in gustilo type-IIIA and type-IIIB open tibial fractures","volume":"88","author":"Rajasekaran","year":"2006","journal-title":"J Bone Joint Surg Br."},{"issue":"4","key":"bib6-20250828","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/j.injury.2020.12.027","article-title":"Is lower limb salvage worthwhile after severe open tibial fractures in a developing country? 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