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

  • General Review • KNEE - BIOMECHANICS
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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.

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References

  1. Klimkiewicz JJ, Petrie RS, Harner CD (2000) Surgical treatment of combined injury to anterior cruciate ligament, posterior cruciate ligament, and medial structures. Clin Sports Med 19:479–92, vii

  2. Rihn JA, Groff YJ, Harner CD, Cha PS (2004) The acutely dislocated knee: evaluation and management. J Am Acad Orthop Surg 12:334–346

    Article  PubMed  Google Scholar 

  3. Brautigan B, Johnson DL (2000) The epidemiology of knee dislocations. Clin Sports Med 19:387–397

    Article  PubMed  CAS  Google Scholar 

  4. Kennedy JC (1963) Complete dislocation of the knee joint. J Bone Jt Surg Am 45:889–904

    Article  CAS  Google Scholar 

  5. Levy BA, Dajani KA, Whelan DB et al (2009) Decision making in the multiligament-injured knee: an evidence-based systematic review. arthroscopy. Arthrosc J Arthrosc Relat Surg 25:430–438. https://doi.org/10.1016/j.arthro.2009.01.008

    Article  Google Scholar 

  6. Fanelli GC, Orcutt DR, Edson CJ (2005) The multiple-ligament injured knee: evaluation, treatment, and results. Arthrosc J Arthrosc Relat Surg 21:471–486. https://doi.org/10.1016/j.arthro.2005.01.001

    Article  Google Scholar 

  7. Hoover NW (1961) Injuries of the popliteal artery associated with fractures and dislocations. Surg Clin N Am 41:1099–1112

    Article  PubMed  CAS  Google Scholar 

  8. Jones RE, Smith EC, Bone GE (1979) Vascular and orthopedic complications of knee dislocation. Surg Gynecol Obstet 149:554–558

    PubMed  CAS  Google Scholar 

  9. Werier J, Keating JF, Meek RN (1998) Complete dislocation of the knee—the long-term results of ligamentous reconstruction. Knee 5:255–260. https://doi.org/10.1016/S0968-0160(98)00015-5

    Article  Google Scholar 

  10. Yeh WL, Tu YK, Su JY, Hsu RW (1999) Knee dislocation: treatment of high-velocity knee dislocation. J Trauma 46:693–701

    Article  PubMed  CAS  Google Scholar 

  11. Harilainen A (1987) Evaluation of knee instability in acute ligamentous injuries. Ann Chir Gynaecol 76:269–273

    PubMed  CAS  Google Scholar 

  12. Krettek C, Schandelmaier P, Lobenhoffer P, Tscherne H (1996) Complex trauma of the knee joint. Diagnosis–management–therapeutic principles. Der Unfallchirurg 99:616–627

    Article  PubMed  CAS  Google Scholar 

  13. Medina O (2014) Vascular and nerve injury after knee dislocation: a systematic review. Clin Orthop Relat Res 472:2621–2629

    Article  PubMed  PubMed Central  Google Scholar 

  14. King JJ, Cerynik DL, Blair JA et al (2009) Surgical outcomes after traumatic open knee dislocation. Knee Surg Sports Traumatol Arthrosc 17:1027–1032. https://doi.org/10.1007/s00167-009-0721-4

    Article  PubMed  Google Scholar 

  15. Almekinders L, Logan T (1992) Results following treatment of traumatic dislocations of the knee joint. Clin Orthop Relat Res (284):203–207

  16. Harner CD, Waltrip RL, Bennett CH et al (2004) Surgical management of knee dislocations. J Bone Jt Surg Am 86–A:262–273

    Article  Google Scholar 

  17. Wascher DC, Dvirnak PC, DeCoster TA (1997) Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma 11:525–529

    Article  PubMed  CAS  Google Scholar 

  18. Liow RYL, McNicholas MJ, Keating JF, Nutton RW (2003) Ligament repair and reconstruction in traumatic dislocation of the knee. J Bone Jt Surg Br 85:845–851. https://doi.org/10.1302/0301-620X.85B6.13972

    Article  CAS  Google Scholar 

  19. Twaddle BC, Bidwell TA, Chapman JR (2003) Knee dislocations: where are the lesions? A prospective evaluation of surgical findings in 63 cases. J Orthop Trauma 17:198–202

    Article  PubMed  Google Scholar 

  20. Georgiadis A, Mohammad F, Mizerik K (2013) Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese. J Vasc Surg 57(5):1196–1203

    Article  PubMed  Google Scholar 

  21. Levy BA, Dajani KA, Whelan DB et al (2009) Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 25:430–438. https://doi.org/10.1016/j.arthro.2009.01.008

    Article  Google Scholar 

  22. Seroyer ST, Musahl V, Harner CD (2008) Management of the acute knee dislocation: the Pittsburgh experience. Injury 39:710–718. https://doi.org/10.1016/j.injury.2007.11.022

    Article  PubMed  CAS  Google Scholar 

  23. Shelbourne KD, Pritchard J, Rettig AC et al (1992) Knee dislocations with intact PCL. Orthop Rev 21(607–8):610–611

    Google Scholar 

  24. Howells NR, Brunton LR, Robinson J et al (2011) Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury 42:1198–1204. https://doi.org/10.1016/j.injury.2010.11.018

    Article  PubMed  Google Scholar 

  25. Bratt HD, Newman AP (1993) Complete dislocation of the knee without disruption of both cruciate ligaments. J Trauma 34:383–389

    Article  PubMed  CAS  Google Scholar 

  26. Cooper D, Speer K, Wickiewicz T, Warren R (1992) Complete knee dislocation without posterior cruciate ligament disruption. A report of four cases and review of the literature. Clin Orthop Relat Res (284):228–233

  27. Schenck RC (2003) Classification of knee dislocations. Oper Tech Sports Med 11:193–198. https://doi.org/10.1053/otsm.2003.35918

    Article  Google Scholar 

  28. Shelbourne KD, Klootwyk TE (2000) Low-velocity knee dislocation with sports injuries. Treat Princ Clin Sports Med 19:443–456

    Article  CAS  Google Scholar 

  29. Wilson TC, Johnson DL (2003) Initial evaluation of the acute multiple-ligament-injured knee. Oper Tech Sports Med 11(3):187–192. https://doi.org/10.1053/otsrn.2003.35912

    Article  Google Scholar 

  30. Halvorson JJ, Anz A, Langfitt M et al (2011) Vascular injury associated with extremity trauma: initial diagnosis and management. J Am Acad Orthop Surg 19:495–504

    Article  PubMed  Google Scholar 

  31. Helgeson MD, Lehman RAJ, Murphy KP (2005) Initial evaluation of the acute and chronic multiple ligament injured knee. J Knee Surg 18:213–219

    Article  PubMed  Google Scholar 

  32. Vinyard TR, Boyd J, MacDonald PB (2012) Initial evaluation of the acute and chronic multiple ligament injured knee. J Knee Surg 25:275–286

    Article  PubMed  Google Scholar 

  33. Nicandri GT, Chamberlain AM, Wahl CJ (2009) Practical management of knee dislocations: a selective angiography protocol to detect limb-threatening vascular injuries. Clin J Sport Med Off J Can Acad Sport Med 19:125–129. https://doi.org/10.1097/JSM.0b013e31819cd37a

    Article  Google Scholar 

  34. Dervin G, Liew A, Simon D et al (2011) Knee dislocation: the ottawa approach. Oper Tech Sports Med 19:12–26. https://doi.org/10.1053/j.otsm.2010.09.011

    Article  Google Scholar 

  35. Kim HM, Stannard JP (2011) How I manage the multiple-ligament injured (dislocated) knee. Oper Tech Sports Med 19:42–50. https://doi.org/10.1053/j.otsm.2010.10.005

    Article  Google Scholar 

  36. Magnussen RA, Riboh JC, Taylor DC, Moorman CT III (2010) How we manage the multiple ligament injured (dislocated) knee. Oper Tech Sports Med 18:211–218. https://doi.org/10.1053/j.otsm.2010.09.008

    Article  Google Scholar 

  37. Merritt AL, Wahl CJ (2011) Rationale and treatment of multiple-ligament injured knees: the seattle perspective. Oper Tech Sports Med 19:51–72. https://doi.org/10.1053/j.otsm.2010.10.008

    Article  Google Scholar 

  38. Nicandri GT, Dunbar RP, Wahl CJ (2010) Are evidence-based protocols which identify vascular injury associated with knee dislocation underutilized? Knee Surg Sports Traumat Arthrosc Off J ESSKA 18:1005–1012. https://doi.org/10.1007/s00167-009-0918-6

    Article  Google Scholar 

  39. Peskun CJ, Levy BA, Fanelli GC et al (2010) Diagnosis and management of knee dislocations. Phys Sportsmed 38:101–111. https://doi.org/10.3810/psm.2010.12.1832

    Article  PubMed  Google Scholar 

  40. Yastrebov O, Lobenhoffer P (2009) Treatment of isolated and multiple ligament injuries of the knee: anatomy, biomechanics, diagnosis, indications for repair, surgery. Der Orthopäde 38:563–580. https://doi.org/10.1007/s00132-009-1421-y

    Article  PubMed  CAS  Google Scholar 

  41. Levy BA, Stuart MJ (2011) How I manage the multiple-ligament injured (dislocated) knee. Oper Tech Sports Med 19:27–33. https://doi.org/10.1053/j.otsm.2010.10.002

    Article  Google Scholar 

  42. Fanelli GC, Stannard JP, Stuart MJ et al (2010) Management of complex knee ligament injuries. J Bone Jt Surg Am 92:2235–2246

    Google Scholar 

  43. Robertson A, Nutton RW, Keating JF (2006) Dislocation of the knee. J Bone Jt Surg Br 88:706–711. https://doi.org/10.1302/0301-620X.88B6.17448

    Article  CAS  Google Scholar 

  44. Gwathmey FW, Shafique DA, Miller MD (2010) Our approach to the management of the multiple-ligament knee injury. Oper Tech Sports Med 18:235–244. https://doi.org/10.1053/j.otsm.2010.09.004

    Article  Google Scholar 

  45. Smith MV, Wojtys EM, Sekiya JK (2011) How we manage the multiple-ligament injured (dislocated) knee. Oper Tech Sports Med 19:34–41. https://doi.org/10.1053/j.otsm.2010.10.007

    Article  Google Scholar 

  46. Vyas D, Harner CD (2011) How I manage the multiple-ligament injured (dislocated) knee. Oper Tech Sports Med 19:2–11. https://doi.org/10.1053/j.otsm.2010.09.010

    Article  Google Scholar 

  47. Redmond JM, Levy BA, Dajani KA et al (2008) Detecting vascular injury in lower-extremity orthopedic trauma: the role of CT angiography. Orthopedics 31:761–767

    Article  PubMed  Google Scholar 

  48. Feliciano DV, Moore FA, Moore EE et al (2011) Evaluation and management of peripheral vascular injury. Part 1. Western trauma association/critical decisions in trauma. J Trauma Injury Infect Crit Care 70:1551–1556. https://doi.org/10.1097/TA.0b013e31821b5bdd

    Article  Google Scholar 

  49. Aboyans V, Ho E, Denenberg JO et al (2008) The association between elevated ankle systolic pressures and peripheral occlusive arterial disease in diabetic and nondiabetic subjects. J Vasc Surg 48:1197–1203. https://doi.org/10.1016/j.jvs.2008.06.005

    Article  PubMed  Google Scholar 

  50. Perkins Z, Yet B, Glasgow S, Cole E (2015) Meta-analysis of prognostic factors for amputation following surgical repair of lower extremity vascular trauma. Br J Surg 102(5):436–450. https://doi.org/10.1002/bjs.9689

    Article  PubMed  CAS  Google Scholar 

  51. Sibbitt RR, Palmaz JC, Garcia F, Reuter SR (1986) Trauma of the extremities: prospective comparison of digital and conventional angiography. Radiology 160:179–182. https://doi.org/10.1148/radiology.160.1.3520645

    Article  PubMed  CAS  Google Scholar 

  52. Abou-Sayed HI, Berger DL (2002) Blunt lower-extremity trauma and popliteal artery injuries: revisiting the case for selective arteriography. Arch Surg 137(5):585–589

    Google Scholar 

  53. Goodman PC, Jeffrey RB, Brant-Zawadzki M (1984) Digital subtraction angiography in extremity trauma. Radiology 153:61–64. https://doi.org/10.1148/radiology.153.1.6382432

    Article  PubMed  CAS  Google Scholar 

  54. Lynch KI, Johansen K (1991) Can doppler pressure measurement replace “exclusion” arteriography in the diagnosis of occult extremity arterial trauma ? Ann Surg 214(6):737–741

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  55. Seddon HJ (1950) Peripheral nerve injuries in Great Britain during World War II; a review. Arch Neurol Psychiatry 63(1):171–173

    PubMed  CAS  Google Scholar 

  56. Gruber H, Peer S, Meirer R, Bodner G (2005) Peroneal nerve palsy associated with knee luxation: evaluation by sonography—initial experiences. Am J Roentgenol 185:1119–1125. https://doi.org/10.2214/AJR.04.1050

    Article  Google Scholar 

  57. Sedel L, Nizard RS (1993) Nerve Grafting for traction injuries of the common peroneal nerve. A report of 17 cases. J Bone Jt Surg 75–B:133-772–4

  58. Wood MB (1991) Peroneal nerve repair. Surgical results. Clin Orthop Relat Res 267:206–210

    Google Scholar 

  59. Behrens FI, Kraft EL, Oegema TR Jr (1989) Biochemical changes in articular cartilage after joint immobilization by casting or external fixation. J Orthop Res 7(3):335–343

    Article  PubMed  CAS  Google Scholar 

  60. Ghosh P, Taylor TKF, Pettit GD et al (1983) Effect of postoperative immobilisation on the regrowth of the knee joint semilunar cartilage: an experimental study. J Orthop Res 1:153–164. https://doi.org/10.1002/jor.1100010206

    Article  PubMed  CAS  Google Scholar 

  61. Klein L, Heiple KG, Torzilli PA et al (1989) Prevention of ligament and meniscus atrophy by active joint motion in a non-weight-bearing model. J Orthop Res 7:80–85. https://doi.org/10.1002/jor.1100070111

    Article  PubMed  CAS  Google Scholar 

  62. Gausepohl T, Pennig D (1998) Luxationen und Luxationsfrakturen des Ellbogens—Einsatz des Bewegungsfixateurs. Ellbogenchirurgie in der Praxis. Springer, Berlin Heidelberg, pp 161–182

    Chapter  Google Scholar 

  63. Mubarak SJ, Owen CA, Hargens AR et al (1978) Acute compartment syndromes: diagnosis and treatment with the aid of the wick catheter. J Bone Jt Surg Am 60:1091–1095

    Article  CAS  Google Scholar 

  64. Kakar S, Firoozabadi R, McKean J, Tornetta P (2007) Diastolic blood pressure in patients with tibia fractures under anaesthesia: implications for the diagnosis of compartment syndrome. J Orthop Trauma 21:99–103. https://doi.org/10.1097/BOT.0b013e318032c4f4

    Article  PubMed  Google Scholar 

  65. McQueen MM, Court-Brown CM (1996) Compartment monitoring in tibial fractures. the pressure threshold for decompression. J Bone Jt Surg 78–B:99–104

    Article  Google Scholar 

  66. Wasserstein D, Henry P, Paterson JM et al (2014) Risk of total knee arthroplasty after operatively treated tibial plateau fracture: a matched-population-based cohort study. J Bone Jt Surg Am 96:144–150. https://doi.org/10.2106/JBJS.L.01691

    Article  Google Scholar 

  67. Archbold HAP, Sloan S, Nicholas R (2004) A tibial plateau fracture in a knee dislocation: a subtle sign of major ligamentous disruption. Injury 35:945–947. https://doi.org/10.1016/j.injury.2004.01.013

    Article  PubMed  CAS  Google Scholar 

  68. Gottsegen CJ, Eyer BA, White EA et al (2008) Avulsion fractures of the knee: imaging findings and clinical significance. Radiogr Rev Publ Radiol Soc N Am 28:1755–1770. https://doi.org/10.1148/rg.286085503

    Article  Google Scholar 

  69. Donaldson WF, Warren RF, Wickiewicz T (1985) A comparison of acute anterior cruciate ligament examinations. Initial versus examination under anesthesia. Am J Sports Med 13:5–10

    Article  PubMed  Google Scholar 

  70. Harilainen A, Myllynen P, Rauste J, Silvennoinen E (1986) Diagnosis of acute knee ligament injuries: the value of stress radiography compared with clinical examination, stability under anaesthesia and arthroscopic or operative findings. Ann Chir Gynaecol 75:37–43

    PubMed  CAS  Google Scholar 

  71. van Eck C, van den Bekerom M, Fu F et al (2013) Methods to diagnose acute anterior cruciate ligament rupture: a meta-analysis of physical examinations with and without anaesthesia. Knee Surg Sports Traumatol Arthrosc 21:1895–1903. https://doi.org/10.1007/s00167-012-2250-9

    Article  PubMed  Google Scholar 

  72. Cho D, Saetia K, Lee S et al (2011) Peroneal nerve injury associated with sports-related knee injury. Neurosurg Focus 31:E11. https://doi.org/10.3171/2011.9.FOCUS11187

    Article  PubMed  Google Scholar 

  73. Tomaino M, Day C, Papageorgiou C et al (2000) Peroneal nerve palsy following knee dislocation: pathoanatomy and implications for treatment. Knee Surg Sports traumatol Arthrosc Off J ESSKA 8:163–165. https://doi.org/10.1007/s001670050208

    Article  CAS  Google Scholar 

  74. Seddon H (1972) Surgical disorders of the peripheral nerves. Churchill Livingstone, London

    Google Scholar 

  75. Boisgard S, Versier G, Descamps S et al (2009) Bicruciate ligament lesions and dislocation of the knee: mechanisms and classification. Orthop Traumatol Surg Res OTSR 95:627–631. https://doi.org/10.1016/j.otsr.2009.10.003

    Article  PubMed  CAS  Google Scholar 

  76. McCoy GF, Hannon DG, Barr RJ, Templeton J (1987) Vascular injury associated with low-velocity dislocations of the knee. J Bone Jt Surg Br 69:285–287. https://doi.org/10.1016/0736-4679(87)90240-X

    Article  CAS  Google Scholar 

  77. Meyers MH, Harvey JP (1971) Traumatic dislocation of the knee joint. A study of eighteen cases. J Bone Jt Surg Am 53:16–29

    Article  CAS  Google Scholar 

  78. Ríos A, Villa A, Fahandezh H et al (2003) Results after treatment of traumatic knee dislocations: a report of 26 cases. J Trauma 55:489–494. https://doi.org/10.1097/01.TA.0000043921.09208.76

    Article  PubMed  Google Scholar 

  79. Sillanpää P, Kannus P, Niemi S et al  (2014) Incidence of knee dislocation and concomitant vascular injury requiring surgery: a nationwide study. J Trauma Acute Care Surg 76(3):715–719

    Article  PubMed  Google Scholar 

  80. Natsuhara K, Yeranosian M, Cohen J et al (2014) What is the frequency of vascular injury after knee dislocation? Clin Orthop Relat Res 472(9):2615–2620  

    Article  PubMed  PubMed Central  Google Scholar 

  81. Green NE, Allen BL (1977) Vascular injuries associated with dislocation of the knee. J Bone Jt Surg Am 59:236–239

    Article  Google Scholar 

  82. Schenck RC (1994) The dislocated knee. Instr Course Lect 43:127–136

    PubMed  Google Scholar 

  83. Weinberg D, Scarcella N, Napora J et al (2016) Can vascular injury be appropriately assessed with physical examination after knee dislocation? Clin Orthop Relat Res 474(6):1453–8. https://doi.org/10.1007/s11999-016-4730-4736

    Article  PubMed  PubMed Central  Google Scholar 

  84. Parker S, Handa A, Deakin M, Sideso E (2015) Knee dislocation and vascular injury: 4 year experience at a UK Major Trauma Centre and vascular hub. Injury. https://doi.org/10.1016/j.injury.2015.11.014

    Article  PubMed  Google Scholar 

  85. López-Hualda A, Valencia-García H, Martínez-Martín J (2012) Vascular injuries associated with dislocation of the knee: diagnosis protocol. Rev Esp Cir Ortop Traumatol 56(4):260–266 (in Spanish). https://doi.org/10.1016/j.recot.2011.12.005

    Article  PubMed  Google Scholar 

  86. Pedersen P, Høgh A (2011) Trampoline accident with anterior knee dislocation caused popliteal artery disruption. Ugeskr Laeger 173(42):2651–2653 (in Danish)

    PubMed  Google Scholar 

  87. McDonough E, Wojtys E (2009) Multiligamentous injuries of the knee and associated vascular injuries. Am J Sports Med 37(1):156–159. https://doi.org/10.1177/0363546508324313. Epub 2008 Oct 8

    Article  PubMed  Google Scholar 

  88. Levy B, Zlowodzki M, Graves M, Cole P (2005) Screening for extermity arterial injury with the arterial injury with the arterial pressure index. Am J Emerg Med 23(5):689–695

    Article  PubMed  Google Scholar 

  89. Stannard JP, Sheils TM, Lopez-Ben RR et al (2004) Vascular injuries in knee dislocations: the role of physical examination in determining the need for arteriography. J Bone Jt Surg Am 86–A:910–915. https://doi.org/10.1016/s0749-4041(08)70257-4

    Article  Google Scholar 

  90. Mills WJ, Barei DP, McNair P (2004) The value of the ankle-brachial index for diagnosing arterial injury after knee dislocation: a prospective study. J Trauma 56:1261–1265. https://doi.org/10.1097/01.TA.0000068995.63201.0B

    Article  PubMed  Google Scholar 

  91. Barnes CJ, Pietrobon RHL (2002) Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta-analysis. J Trauma 53:1109–1114

    Article  PubMed  Google Scholar 

  92. Hollis J, Daley B (2005) 10-year review of knee dislocations: is arteriography always necessary? J Trauma Acute Care Surg 59:672–676

    Google Scholar 

  93. Kendall RW, Taylor DC, Salvian AJ, O’Brien PJ (1993) The role of arteriography in assessing vascular injuries associated with dislocations of the knee. J Trauma 35:875–878

    Article  PubMed  CAS  Google Scholar 

  94. Klineberg E, Crites B, Flinn W (2004) The role of arteriography in assessing popliteal artery injury in knee dislocations. J Trauma 56(4):786–790

    Article  PubMed  Google Scholar 

  95. Martinez D, Sweatman K, Thompson E (2001) Popliteal artery injury associated with knee dislocations. Am Surg 67(2):165–167

    PubMed  CAS  Google Scholar 

  96. Treiman GS, Yellin AE, Weaver FA, et al (1992) Examination of the patient with a knee dislocation. The case for selective arteriography. Arch Surg (Chicago, Ill : 1960) 127:1056-62–3

  97. Miranda FE, Dennis JW, Veldenz HC et al (2002) Confirmation of the safety and accuracy of physical examination in the evaluation of knee dislocation for injury of the popliteal artery: a prospective study. J Trauma 52:247–251-252. https://doi.org/10.1097/00005373-200202000-00008

    Article  PubMed  Google Scholar 

  98. Boisrenoult P, Lustig S, Bonneviale P et al (2009) Vascular lesions associated with bicruciate and knee dislocation ligamentous injury. Orthop Traumatol Surg Res OTSR 95:621–626. https://doi.org/10.1016/j.otsr.2009.10.002

    Article  PubMed  CAS  Google Scholar 

  99. Niall DM, Nutton RW, Keating JF (2005) Palsy of the common peroneal nerve after traumatic dislocation of the knee. J Bone Jt Surg Br 87:664–667. https://doi.org/10.1302/0301-620X.87B5.15607

    Article  CAS  Google Scholar 

  100. Mook WR, Ligh CA, Moorman CT 3rd, Leversedge FJ (2013) Nerve injury complicating multiligament knee injury: current concepts and treatment algorithm. J Am Acad Orthop Surg 21:343–354

    PubMed  Google Scholar 

  101. Woodmass JM, Romatowski NPJ, Esposito JG et al (2015) A systematic review of peroneal nerve palsy and recovery following traumatic knee dislocation. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 23:2992–3002. https://doi.org/10.1007/s00167-015-3676-7

    Article  Google Scholar 

  102. White J (1968) The results of traction inureis to the common peroneal nerve. J Bone Jt Surg 50 B:346–350

    Article  Google Scholar 

  103. Coraci D, Tsukamoto H, Granata G, Briani C et al (2015) Fibular nerve damage in knee dislocation: Spectrum of ultrasound patterns. Muscle Nerve 51(6):859–863

    Article  PubMed  Google Scholar 

  104. Molund M, Engebretsen L, Hvaal K, Hellesnes J et al (2014) Posterior tibial tendon transfer improves function for foot drop after knee dislocation. Clin Orthop Relat Res 472(9):2637–2643. https://doi.org/10.1007/s11999-014-3533-x

    Article  PubMed  PubMed Central  Google Scholar 

  105. Stuart MJ (2001) Evaluation and treatment principlesof knee dislocations. Oper Tech Sports Med 9:91–95. https://doi.org/10.1053/otsm.2001.21769

    Article  Google Scholar 

  106. Levy BA, Fanelli GC, Whelan DB et al (2009) Controversies in the treatment of knee dislocations and multiligament reconstruction. J Am Acad Orthop Surg 17:197–206

    Article  PubMed  Google Scholar 

  107. Bibbo C, Brueggeman J (2010) Prevention and management of complications arising from external fixation pin sites. J Foot Ankle Surg 49:87–92. https://doi.org/10.1053/j.jfas.2009.07.026

    Article  PubMed  Google Scholar 

  108. Zhang C, Li J (2016) Comments on: Surgical management of knee dislocations with ligament reconstruction associated with a hinged external fixator by Angelini FJ, Helito CP, Bonadio MB, da Mota E Albuquerque RF, Pecora JR, Camanho GL published in Orthop Traumatol Surg Res 2015 Feb 101(1):77–81. Orthop Traumatol Surg Res 102(1):139

    Article  PubMed  CAS  Google Scholar 

  109. Angelini FJ, Helito CP, Bonadio MB et al (2015) External fixator for treatment of the sub-acute and chronic multi-ligament-injured knee. Knee Surg Sports Traumatol Arthrosc 23:3012–3018. https://doi.org/10.1007/s00167-015-3719-0

    Article  PubMed  Google Scholar 

  110. Stannard JP, Nuelle CW, McGwin G, Volgas DA (2014) Hinged external fixation in the treatment of knee dislocations. J Bone Jt Surg Am 96:184–191. https://doi.org/10.2106/JBJS.L.01603

    Article  Google Scholar 

  111. Engebretsen L, Risberg MA, Robertson B et al (2009) Outcome after knee dislocations: a 2–9 years follow-up of 85 consecutive patients. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 17:1013–1026. https://doi.org/10.1007/s00167-009-0869-y

    Article  Google Scholar 

  112. Hirschmann MT, Zimmermann N, Rychen T et al (2010) Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair. BMC Musculoskel Disorders 11:102. https://doi.org/10.1186/1471-2474-11-102

    Article  Google Scholar 

  113. Ibrahim S, Ahmad F, Salah M et al (2008) Surgical management of traumatic knee dislocation. J Arthrosc 24(2):178–187. https://doi.org/10.1016/j.arthro.2007.08.007

    Article  Google Scholar 

  114. Gausepohl T, Pennig D (1998) Luxationen und Luxationsfrakturen des Ellbogens—Einsatz des Bewegungsfixateurs. In: Meyer R, Kappeler U (eds) Ellbogenchirurgie in der Praxis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72228-8_9

  115. Koslowsky TC, Schadt R, Mader K, Pennig D (2011) Der Bewegungsfixateur bei komplexer Kniegelenkluxation mit Begleitverletzung. Der Unfallchirurg 114:136–140. https://doi.org/10.1007/s00113-010-1932-3

    Article  PubMed  CAS  Google Scholar 

  116. Zaffagnini S, Iacono F, Presti M, Di Martino A et al (2008) A new hinged dynamic distractor, for immediate mobilization after knee dislocations: Technical note. Arch Orthop Trauma Surg 128(11):1233–1237

    Article  Google Scholar 

  117. Marcacci M, Zaffagnini S, Bonanzinga T et al (2012) Surgical technique: articulated external fixator for treatment of complex knee dislocation. Clin Orthop Relat Res® 470(3):869–876. https://doi.org/10.1007/s11999-011-2062-0

    Article  Google Scholar 

  118. Sommers M, Fitzpatrick D, Kahn K et al (2004) Hinged external fixation of the knee: intrinsic factors influencing passive joint motion. J Orthop Trauma 18(3):163–169

    Article  PubMed  Google Scholar 

  119. Siston R, Patel J, Goodman S et al (2005) The variability of femoral rotational alignment in total knee arthroplasty. J Bone Joint Surg Am 87(10):2276–2280

    PubMed  Google Scholar 

  120. Jenny J, Boeri C (2004) Low reproducibility of the intra–operative measurement of the transepicondylar axis during total knee replacement. Acta Orthop Scand 75(1):74–77

    Article  PubMed  Google Scholar 

  121. Richter M, Lobenhoffer P (1998) Chronic posterior knee dislocation: treatment with arthrolysis, posterior cruciate ligament reconstruction and hinged external fixation device. Injury 29:546–549

    Article  PubMed  CAS  Google Scholar 

  122. Simonian P, Wickiewicz T et al (1998) Chronic knee dislocation: reduction, reconstruction, and application of a skeletally fixed knee hinge a report of two cases. Am J Sports Med 26(4):591–596

    Article  PubMed  CAS  Google Scholar 

  123. Geiger E, Arzeno A, Medvecky M (2016) Hinged-knee external fixator used to reduce and maintain subacute tibiofemoral coronal subluxation. Am J Orthop (Belle Mead, NJ) 45(7):E497–E502

    Google Scholar 

  124. Henshaw R, Shapiro M, Oppenheim W (1996) Delayed reduction of traumatic knee dislocation: a case report and literature review. Clin Orthop Relat Res 330:152–156

    Article  Google Scholar 

  125. Van Thiel G, Baker C 3rd, Bush-Joseph C (2009) A chronic posterolateral knee and patella dislocation: case report. J Orthop Trauma 23(7):541–545. https://doi.org/10.1097/BOT.0b013e3181a27e64

    Article  Google Scholar 

  126. Saini R, Mootha AK, Goni VG, Dhillon MS (2010) Neglected irreducible posterolateral knee dislocation. Indian J Orthop 44:468–470. https://doi.org/10.4103/0019-5413.69323

    Article  PubMed  PubMed Central  Google Scholar 

  127. Polyzois V, Stathopoulos I, Benetos I et al (2016) A Two-stage procedure for the treatment of a neglected posterolateral knee dislocation: Gradual reduction with an Ilizarov external fixator followed by arthroscopic. The Knee 23(1):181–184. https://doi.org/10.1016/j.knee.2015.08.009

    Article  PubMed  Google Scholar 

  128. Vicente-Guillen P, Figa-Mataró J, Coloma-Bellver J (1998) Long-standing unreduced dislocation of the knee. A case report. Int Orthop 22(4):275–276

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  129. Watanabe K, Yamada Y, Kura H, Itou M et al (2001) Chronic knee fracture dislocation treated by the Ilizarov technique: case report. J Trauma 50(1):151–154

    Article  PubMed  CAS  Google Scholar 

  130. Polyzois V, Grivas T, Stamatis E, et al (2008) Management of knee dislocation because of posttraumatic septic arthritis neglected for 40 years. J Trauma 64(2):E21–E23. https://doi.org/10.1097/01.ta.0000198205.48191.10

    Article  PubMed  Google Scholar 

  131. Fanelli GC, Edson CJ (2012) Surgical treatment of combined PCL-ACL medial and lateral side injuries (global laxity): surgical technique and 2- to 18-year results. J Knee Surg 25:307–316. https://doi.org/10.1055/s-0032-1326997

    Article  PubMed  Google Scholar 

  132. Levy BA, Krych AJ, Shah JP et al (2010) Staged protocol for initial management of the dislocated knee. Knee Surg Sports Traumatol Arthrosc 18:1630–1637. https://doi.org/10.1007/s00167-010-1209-y

    Article  PubMed  Google Scholar 

  133. Petrie R, Trousdale R, Cabanela M (2000) Total knee arthroplasty for chronic posterior knee dislocation: report of 2 cases with technical considerations. J Arthroplasty 15(3):380–386

    Article  PubMed  CAS  Google Scholar 

  134. Chen H, Chiu F (2007) Chronic knee dislocation treated with arthroplasty. Case report. Injury Extra 38(8):258–261. https://doi.org/10.1016/j.injury.2006.10.025

    Article  Google Scholar 

  135. Javidan P, Owen J, Cutuk A, Watson T et al (2015) How do spanning external fixators on knee dislocation patients affect the use of MRI and knee stability? J Knee Surg 28(3):247–254. https://doi.org/10.1055/s-0034-1386579

    Article  Google Scholar 

  136. Sekiya JK (2008) A clinically relevant assessment of posterior cruciate ligament and posterolateral corner injuries. Evaluation of isolated and combined deficiency. J Bone Jt Surg 90:1621. https://doi.org/10.2106/jbjs.g.01365

    Article  Google Scholar 

  137. Quinlan AG, Sharrard WJW (1958) Posterolateral Doslocation of the Knee with Capsular Interposition. J Bone Jt Surg 40–B:660–663

    Article  Google Scholar 

  138. Nystrom M, Samimi S, Ha’Eri GB (1992) Two cases of irreducible knee dislocation occurring simultaneously in two patients and a review of the literature. Clin Orthop Relat Res (277):197–200

  139. Siegmeth A, Menth-Chiari WA, Amsuess H (2000) A rare case of irreducible knee dislocation in a seventy-three-year-old male. J Orthop Trauma 14:70–72

    Article  PubMed  CAS  Google Scholar 

  140. Chirpaz-Cerbat JM, Rossi J, Melere G, Martinez T (2004) Irreducible knee dislocation by medial capsulo-ligament incarceration. Revue de chirurgie orthopédique et réparatrice de l’appareil moteur 90:449–455

    Article  PubMed  Google Scholar 

  141. Chen W, Zhang YZ, Su YL, Pan JP (2011) Irreducible lateral knee dislocation with incarceration of the lateral femoral condyle in the posterolateral capsuloligamentary structures: a case report and literature review. Orthop Surg 3:138–142

    Article  PubMed  CAS  Google Scholar 

  142. Matsen F, Winquist RA, Krugmire RB (1980) Diagnosis and management of compartmental syndromes. J Bone Jt Surg 62:286–291. https://doi.org/10.1016/S0300-9084(80)80330-0

    Article  Google Scholar 

  143. Jeevannavar SS, Shettar CM (2013) “Pucker sign” an indicator of irreducible knee dislocation. BMJ Case Rep 2013:bcr2013201279. https://doi.org/10.1136/bcr-2013-201279

    Article  PubMed  PubMed Central  Google Scholar 

  144. Wand JS (1989) A physical sign denoting irreducibility of a dislocated knee. J Bone Jt Surg Br 71:862

    Article  CAS  Google Scholar 

  145. Reckling FW, Peltier LF (1969) Acute knee dislocations and their complications. J Trauma 9:181–191

    Article  PubMed  CAS  Google Scholar 

  146. Neyret P, Rongieras F, Versier G, Selmi TAS (2002) Esska symposium. Physiopathologie, mécanismes et classifications des lésions bicroisées. Le genou du sportif Montpellier Sauramps Medical 375–386

  147. Sabesan VJ, Danielsky PJ, Childs A, Valikodath T (2015) Multiligament knee injuries with associated tibial plateau fractures: a report of two cases. World J Orthop 6:363–368. https://doi.org/10.5312/wjo.v6.i3.363

    Article  PubMed  PubMed Central  Google Scholar 

  148. Leroux T, Ogilvie-Harris D, Dwyer T et al (2014) The risk of knee arthroplasty following cruciate ligament reconstruction: a population-based matched cohort study. J Bone Jt Surg Am 96:2–10. https://doi.org/10.2106/JBJS.M.00393

    Article  Google Scholar 

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  1. Department of Orthopaedics, Rudolf-Elle-Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klostersnitzer Straße 81, 07607, Eisenberg, Germany

    Alexander Maslaris, Olaf Brinkmann & Matthias Bungartz

  2. Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Christian Krettek, Michael Jagodzinski & Emmanouil Liodakis

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Maslaris, A., Brinkmann, O., Bungartz, M. et al. Management of knee dislocation prior to ligament reconstruction: What is the current evidence? Update of a universal treatment algorithm. Eur J Orthop Surg Traumatol 28, 1001–1015 (2018). https://doi.org/10.1007/s00590-018-2148-4

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