Knee Dislocations

  • Samuel N. CrosbyJr.
  • Manish K. Sethi
  • William T. Obremskey
Chapter

Abstract

MS is a 33-year-old male who presents to the emergency department after sustaining a motorcycle accident in which he slid on a patch of ice and lost control of his motorcycle. Upon presentation to the emergency department, his chief complaint is of right knee and leg pain. On primary survey, he demonstrates a GCS of 15, a patent airway, and is hemodynamically stable. On secondary survey, no gross deformity is noted to his right lower extremity.

Keywords

Knee dislocations Neurovascular injury Repair versus reconstruction of ACL and PCL Early versus late repair of knee ligaments Open versus arthroscopic repair of knee ligaments 

References

  1. 1.
    O’Shea KJ, Murphy KP, Heekin RD, et al. The diagnostic accuracy of history, physical examination, and radiographs in the evaluation of traumatic knee disorders. Am J Sports Med. 1996;24:164–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Twaddle BC, Hunter JC, Chapman JR, et al. MRI in acute knee dislocation. A prospective study of clinical, MRI, and surgical findings. J Bone Joint Surg Br. 1996;78:573–9.PubMedGoogle Scholar
  3. 3.
    Silverberg DA, Acus R. Irreducible posterolateral knee dislocation associated with interposition of the vastus medialis. Am J Sports Med. 2004;32:1313–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Walker DM, Kennedy JC. Occult knee ligament injuries associated with femoral shaft fractures. Am J Sports Med. 1980;8:172–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Wascher DC, Dvirnak PC, DeCoster TA. Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma. 1997;11:525–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Green NE, Allen BL. Vascular injuries associated with dislocation of the knee. J Bone Joint Surg Am. 1977;59:236–9.PubMedGoogle Scholar
  7. 7.
    Patterson BM, Agel J, Swiontkowski MF, et al. Knee dislocations with vascular injury: outcomes in the Lower Extremity Assessment Project (LEAP) Study. J Trauma. 2007;63:855–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Stannard JP, Sheils TM, Lopez-Ben RR, et al. Vascular injuries in knee dislocations: the role of physical examination in determining the need for arteriography. J Bone Joint Surg Am. 2004;86-A:910–915.Google Scholar
  9. 9.
    Mills WJ, Barei DP, McNair P. The value of the ankle-brachial index for diagnosing arterial injury after knee dislocation: a prospective study. J Trauma. 2004;56:1261–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Busquets AR, Acosta JA, Colon E, et al. Helical computed tomographic angiography for the diagnosis of traumatic arterial injuries of the extremities. J Trauma. 2004;56:625–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Niall DM, Nutton RW, Keating JF. Palsy of the common peroneal nerve after traumatic dislocation of the knee. J Bone Joint Surg Br. 2005;87:664–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Levy BA, Krych AJ, Shah JP, et al. Staged protocol for initial management of the dislocated knee. Knee Surg Sports Traumatol Arthrosc. 2010;18:1630–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Dedmond BT, Almekinders LC. Operative versus nonoperative treatment of knee dislocations: a meta-analysis. Am J Knee Surg. 2001;14:33–8.PubMedGoogle Scholar
  14. 14.
    Richter M, Bosch U, Wippermann B, et al. Comparison of surgical repair or reconstruction of the cruciate ligaments versus nonsurgical treatment in patients with traumatic knee dislocations. Am J Sports Med. 2002;30:718–27.PubMedGoogle Scholar
  15. 15.
    Harner CD, Waltrip RL, Bennett CH, et al. Surgical management of knee dislocations. J Bone Joint Surg Am. 2004;86-A:262–73.Google Scholar
  16. 16.
    Liow RY, McNicholas MJ, Keating JF, et al. Ligament repair and reconstruction in traumatic dislocation of the knee. J Bone Joint Surg Br. 2003;85:845–51.PubMedGoogle Scholar
  17. 17.
    Owens BD, Neault M, Benson E, et al. Primary repair of knee dislocations: results in 25 patients (28 knees) at a mean follow-up of four years. J Orthop Trauma. 2007;21:92–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Mariani PP, Santoriello P, Iannone S, et al. Comparison of surgical treatments for knee dislocation. Am J Knee Surg. 1999;12:214–21.PubMedGoogle Scholar
  19. 19.
    Stannard JP, Brown SL, Farris RC, et al. The posterolateral corner of the knee: repair versus reconstruction. Am J Sports Med. 2005;33:881–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Wascher DC. High-velocity knee dislocation with vascular injury. Treatment principles. Clin Sports Med. 2000;19:457–77.PubMedCrossRefGoogle Scholar
  21. 21.
    Taylor AR, Arden GP, Rainey HA. Traumatic dislocation of the knee. A report of forty-three cases with special reference to conservative treatment. J Bone Joint Surg Br. 1972;54:96–102.PubMedGoogle Scholar
  22. 22.
    Fanelli GC, Stannard JP, Stuart MJ, et al. Management of complex knee ligament injuries. J Bone Joint Surg Am. 2010;92:2235–46.PubMedGoogle Scholar
  23. 23.
    Ohkoshi Y, Nagasaki S, Shibata N, et al. Two-stage reconstruction with autografts for knee dislocations. Clin Orthop Relat Res. 2002:169–75.Google Scholar
  24. 24.
    Rihn JA, Groff YJ, Harner CD, et al. The acutely dislocated knee: evaluation and management. J Am Acad Orthop Surg. 2004;12:334–46.PubMedGoogle Scholar
  25. 25.
    Fanelli GC, Edson CJ. Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction in the multiple ligament injured knee: 2- to 10-year follow-up. Arthroscopy. 2002;18:703–14.PubMedCrossRefGoogle Scholar
  26. 26.
    Wascher DC, Becker JR, Dexter JG, et al. Reconstruction of the anterior and posterior cruciate ligaments after knee dislocation. Results using fresh-frozen nonirradiated allografts. Am J Sports Med. 1999;27:189–96.PubMedGoogle Scholar
  27. 27.
    Kwon OS, Park MJ, Kelly JDt. Arthroscopic treatment of a PCL avulsion fracture in a skeletally immature patient. Orthopedics. 2011;34:137.PubMedGoogle Scholar
  28. 28.
    Shelbourne KD, Klootwyk TE. Low-velocity knee dislocation with sports injuries. Treatment principles. Clin Sports Med. 2000;19:443–56.PubMedCrossRefGoogle Scholar
  29. 29.
    Levy BA, Dajani KA, Morgan JA, et al. Repair versus reconstruction of the fibular collateral ligament and posterolateral corner in the multiligament-injured knee. Am J Sports Med. 2010;38:804–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Levy BA, Fanelli GC, Whelan DB, et al. Controversies in the treatment of knee dislocations and multiligament reconstruction. J Am Acad Orthop Surg. 2009;17:197–206.PubMedGoogle Scholar
  31. 31.
    Stannard JP, Sheils TM, McGwin G, et al. Use of a hinged external knee fixator after surgery for knee dislocation. Arthroscopy. 2003;19:626–31.PubMedCrossRefGoogle Scholar
  32. 32.
    Simonian PT, Wickiewicz TL, Hotchkiss RN, et al. Chronic knee dislocation: reduction, reconstruction, and application of a skeletally fixed knee hinge. A report of two cases. Am J Sports Med. 1998;26:591–6.PubMedGoogle Scholar
  33. 33.
    Fanelli GC, Giannotti BF, Edson CJ. Arthroscopically assisted combined posterior cruciate ligament/posterior lateral complex reconstruction. Arthroscopy. 1996;12:521–30.PubMedCrossRefGoogle Scholar
  34. 34.
    Fanelli GC, Giannotti BF, Edson CJ. Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction. Arthroscopy. 1996;12:5–14.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Samuel N. CrosbyJr.
    • 1
  • Manish K. Sethi
    • 1
  • William T. Obremskey
    • 1
  1. 1.Department of Orthopedic Surgery and RehabilitationVanderbilt Medical CenterNashvilleUSA

Personalised recommendations