Knee Dislocation

Chapter
Part of the European Instructional Lectures book series (EICL, volume 14)

Abstract

Knee dislocation is a devastating injury that necessitates a prompt diagnosis. Considering the final position of the tibia with respect to the femur, the dislocation can be classified as anterior, posterior, medial, lateral or rotatory. Reduction must be rapidly performed if necessary. Vascular and neurological status must also be repetitively evaluated. Emergency repair of any vascular injury has to be performed. In general, surgical repair of all ligamentous lesions is recommended in the “therapeutic window” between 10 and 20 days. Proper treatment leads to 80 % good to excellent results.

Keywords

Ischemia Immobilization Osteoarthritis Pentad 

References

  1. 1.
    Boisrenoult P, Lustig S, Bonneviale P, et al. Vascular lesions associated with bicruciate and knee dislocation ligamentous injury. Orthop Traumatol Surg Res. 2009;95:621–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Dedmond BT, Almekinders LC. Operative versus nonoperative treatment of knee dislocations: a meta-analysis. Am J Knee Surg. 2001;14:33–8.PubMedGoogle Scholar
  3. 3.
    Engebretsen L, Risberg MA, Robertson B, et al. Outcome after knee dislocations: a 2 to 9 years follow-up of 85 patients. Knee Surg Sports Traumatol Arthrosc. 2009;1:1013–26.CrossRefGoogle Scholar
  4. 4.
    Frosch KH, Preiss A, Heider S, et al. Primary ligament sutures as a treatment option of knee dislocations: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2013;21:1502–9.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Green NE, Allen BL. Vascular injuries associated with dislocation of the knee. J Bone Joint Surg Am. 1977;59:236–9.PubMedGoogle Scholar
  6. 6.
    Harner CD, Waltrip RL, Bennett CH, et al. Surgical management of knee dislocations. J Bone Joint Surg Am. 2004;86-A:262–73.PubMedGoogle Scholar
  7. 7.
    Hill JA, Rana NA. Complications of posterolateral dislocation of the knee: case report and literature review. Clin Orthop Relat Res. 1981;151:212–5.Google Scholar
  8. 8.
    Hoover NW. Injuries of the popliteal artery associated with fractures and dislocations. Surg Clin North Am. 1961;41:1099–112.PubMedGoogle Scholar
  9. 9.
    Howells NR, Brunton LR, J R, et al. Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury. 2011;42:1198–204.PubMedCrossRefGoogle Scholar
  10. 10.
    Jones RE, Smith EC, Bone GE. Vascular and orthopedic complications of knee dislocation. Surg Gynecol Obstet. 1979;149:554–8.PubMedGoogle Scholar
  11. 11.
    Kennedy JC. Complete dislocation of the knee joint. J Bone Joint Surg Am. 1963;45:889–904.PubMedGoogle Scholar
  12. 12.
    King 3rd JJ, Cerynick DL, Blair JA, et al. Surgical outcome after traumatic open knee dislocation. Knee Surg Sports Traumatol Arthrosc. 2009;17:1027–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Klimkiewicz JJ, Petrie RS, Harner CD. Surgical treatment of combined injury to anterior cruciate ligament, posterior cruciate ligament, and medial structures. Clin Sports Med. 2000;19:479–92.PubMedCrossRefGoogle Scholar
  14. 14.
    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
  15. 15.
    Levy BA, Dajani KA, Whelan DB, et al. Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy. 2009;25:430–8.PubMedCrossRefGoogle Scholar
  16. 16.
    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
  17. 17.
    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
  18. 18.
    McCoy GF, Hannon DG, Barr RJ, Templeton J. Vascular injury associated with low-velocity dislocations of the knee. J Bone Joint Surg Br. 1987;69:285–7.PubMedGoogle Scholar
  19. 19.
    Meyers MH, Harvey Jr JP. Traumatic dislocation of the knee joint. A study of eighteen cases. J Bone Joint Surg Am. 1971;53:16–29.PubMedGoogle Scholar
  20. 20.
    Neyret P, Rongieras F, Versier G, Aït Si Selmi T. Physiopathologie, mécanismes et classification des lésions bicroisées. In: Le genou du sportif. Paris: Sauramps Médical; 2002. p. 375–86.Google Scholar
  21. 21.
    Neyret Ph. Lésions ligamentaires complexes récentes: triades, pentades et luxations. In: Saillant G, éditors. Pathologies chirurgicales du genou du sportif. Cahiers d’enseignement de la SOFCOT. vol. 59. Expansion Scientifique Française, Paris; 1996. p. 37–52.Google Scholar
  22. 22.
    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
  23. 23.
    Nicandri GT, Chamberlain AM, Wahl CJ. Practical management of knee dislocations: a selective angiography protocol to detect lim-threatening vascular injuries. Clin J Sport Med. 2009;19:125–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Pace A, Fergusson C. Spontaneous non-traumatic dislocation of the knee. Acta Orthop Belg. 2004;70:498–501.PubMedGoogle Scholar
  25. 25.
    Potter HG, Weinstein M, Allen AA, et al. Magnetic resonance imaging of the multiple-ligament injured knee. J Orthop Trauma. 2002;1:330–9.CrossRefGoogle Scholar
  26. 26.
    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
  27. 27.
    Rios A, Villa A, Fahandezh H, et al. Results after treatment of traumatic knee dislocations: a report of 26 cases. J Trauma. 2003;55:489–94.PubMedCrossRefGoogle Scholar
  28. 28.
    Sharma H, Singh GK, Gupta M, Moss M. Type IIIb tibial intercondylar eminence fracture associated with a complex knee dislocation in a grossly obese adult. Knee Surg Sports Traumatol Arthrosc. 2005;13:313–6.PubMedCrossRefGoogle Scholar
  29. 29.
    Schenck Jr RC. The dislocated knee. Instr Course Lect. 1994;43:127–36.PubMedGoogle Scholar
  30. 30.
    Shetty RR, Mostofi SB, Housden PL. Knee dislocation of a morbidly obese patient: a case report. J Orthop Surg (Hong Kong). 2005;13:76–8.Google Scholar
  31. 31.
    Shelbourne KD, Porter DA, Clingman JA, et al. Low velocity knee dislocation. Orthop Rev. 1991;20:995–1004.PubMedGoogle Scholar
  32. 32.
    Shields L, Mital M, Cave EF. Complete dislocation of the knee: experience at the Massachusetts General Hospital. J Trauma. 1969;9:192–215.PubMedCrossRefGoogle Scholar
  33. 33.
    Sisto DJ, Warren RF. Complete knee dislocation. A follow-up study of operative treatment. Clin Orthop Relat Res. 1985;198:94–101.Google Scholar
  34. 34.
    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:910–5.PubMedGoogle Scholar
  35. 35.
    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
  36. 36.
    Treiman Yellin AE, Weaver FA, et al. Examination of the patient with a knee dislocation. The case for selective arteriography. Arch Surg. 1992;127:1056–62.CrossRefGoogle Scholar
  37. 37.
    Tzurbakis M, Diamantopoulos A, Xenakis T. Surgical treatment of multiple knee ligament injuries in 44 patients: 2–8 years follow-up results. Knee Surg Sports Traumatol Arthrosc. 2006;14:739–49.PubMedCrossRefGoogle Scholar
  38. 38.
    Yeh WL, Tu YK, Su JY, Hsu RW. Knee dislocation: treatment of high-velocity knee dislocation. J Trauma. 1999;46:693–701.PubMedCrossRefGoogle Scholar
  39. 39.
    Walker RE, et al. Radiologic review of knee dislocation: from diagnosis to repair. AJR Am J Roentgenol. 2013;201:483–95.PubMedCrossRefGoogle Scholar
  40. 40.
    Wascher DC, Dvirnak PC, DeCoster TA. Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma. 1997;11:525–9.PubMedCrossRefGoogle Scholar
  41. 41.
    Werier J. Complete dislocation of the knee – the long term results of ligamentous reconstruction. Knee. 1998;5:255–66.CrossRefGoogle Scholar

Copyright information

© EFORT 2014

Authors and Affiliations

  1. 1.Centre de médecine de l’appareil locomoteur et du sport - HUG Service de chirurgie orthopédique et traumatologie de l’appareil moteur, Unité d’Orthopédie et Traumatologie du Sport (UOTS)University Hospital of Geneva, Faculty of MedicineGeneve 14Switzerland

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