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Nonoperative Treatment of the Dislocated Knee

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The Multiple Ligament Injured Knee

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Abstract

Historically, knee dislocations have been rare but serious traumatic injuries that require prompt diagnosis and treatment. Studies have reported incidence ranging from 0.001 to 0.013 %, although the true incidence is higher as many dislocations spontaneously reduce in the field. Over the last century both the incidence of knee dislocation and the mechanism of injury have changed. Improvements in automotive safety features, as well as new trauma and EMT training, have increased the number of people surviving high-speed motor vehicle accidents, leading to a greater population of multi-trauma patients with knee dislocations. In addition, a new mechanism for knee dislocations has become prevalent with the obesity epidemic in America. Hangio et al. reported on 7 cases of spontaneous knee dislocations while standing in patients with morbid obesity. From 1911 to 1960 only 14 knee dislocations were identified in a review of two million admissions at the Mayo Clinic. At that time, immobilization in a long-leg cast was the initial treatment standard. There is now strong evidence that patients treated nonoperatively have increased instability, more pain with activities of daily living, worse functional outcomes, and develop increased rates of degenerative arthritis compared to their operative counterparts. With modern technology, including MRI and arthroscopy, newer outcome studies have favored operative intervention for patients with knee dislocations. To follow are the historic treatment and outcomes of knee dislocations that drove the treatment pendulum from primarily closed treatment or amputation to present day reconstruction.

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Authors and Affiliations

  1. Orthopaedic Surgery Department, Geisinger Medical Center, Danville, PA, USA

    John David Beck M.D., Kaan Irgit M.D. & John T. Riehl M.D.

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  1. John David Beck M.D.
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  2. Kaan Irgit M.D.
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  3. John T. Riehl M.D.
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Correspondence to John David Beck M.D. .

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  1. GHS Orthopaedics, Woodbine Lane 115, Danville, 17822-5212, Pennsylvania, USA

    Gregory C. Fanelli

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Beck, J.D., Irgit, K., Riehl, J.T. (2013). Nonoperative Treatment of the Dislocated Knee. In: Fanelli, G. (eds) The Multiple Ligament Injured Knee. Springer, New York, NY. https://doi.org/10.1007/978-0-387-49289-6_8

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  • DOI: https://doi.org/10.1007/978-0-387-49289-6_8

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