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Management of knee dislocation prior to ligament reconstruction: What is the current evidence? Update of a universal treatment algorithm

  • Alexander Maslaris
  • Olaf Brinkmann
  • Matthias Bungartz
  • Christian Krettek
  • Michael Jagodzinski
  • Emmanouil Liodakis
General Review • KNEE - BIOMECHANICS

Abstract

Traumatic knee dislocation is a rare but potentially limb-threatening injury. Thus proper initial diagnosis and treatment up to final ligament reconstruction are extremely important and a precondition to successful outcomes. Reports suggest that evidence-based systematic approaches lead to better results. Because of the complexity of this injury and the inhomogeneity of related literature, there are still various controversies and knowledge gaps regarding decision-making and step-sequencing in the treatment of acute multi-ligament knee injuries and knee dislocations. The use of ankle-brachial index, routine or selective angiography, braces, joint-spanning or dynamic external fixation, and the necessity of initial ligament re-fixation during acute surgery constitutes current topics of a scholarly debate. The aim of this article was to provide a comprehensive literature review bringing light into some important aspects about the initial treatment of knee dislocation (vascular injury, neural injury, immobilization techniques) and finally develop an accurate data-based universal algorithm, enabling attending physicians to become more acquainted with the management of acute knee dislocation.

Keywords

Knee dislocation MLKI Initial management Protocol Vascular injury Nerve injury Immobilization Fixator Brace Cast 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedics, Rudolf-Elle-HospitalFriedrich-Schiller-University of JenaEisenbergGermany
  2. 2.Trauma DepartmentHannover Medical SchoolHannoverGermany

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