Abstract
Traumatic knee dislocation is a serious and potentially limb threatening injury that can be easily missed if meticulous history and examination have not been employed. Neurovascular injuries are common in this condition, and due diligence should be given to their thorough evaluation at time of secondary survey so as to avoid complications such as ischaemia, compartment syndrome and eventual amputation. There is growing evidence in the literature that morbid obesity is associated with low energy knee dislocation, therefore this should be considered when assessing this cohort of patients presenting with an acute knee injury. Early operative intervention especially with multi ligaments involvement is the preferable strategy in the management of this acute injury. Controversy exists whether to reconstruct or repair damaged structures, and whether to adopt a one stage or two stage reconstruction of the cruciate ligaments. Early rehabilitation is important and essential to achieve satisfactory outcomes. This article is an evidence-based overview of this rare but devastating injury.
Highlights
Traumatic knee dislocation (KD) is a serious and potentially limb threatening injury, albeit a relatively rare condition: the incidence has been reported as approximately 0.02-0.2% of orthopaedic injuries [1,2,3]
There is some variance on the definition of knee dislocation, though it can be generally considered to include disruption of at least 2 out of 6 of the major ligamentous and cartilaginous structures, with or without instability
These injuries have historically been attributed to high velocity impacts (HVKD) more recently they are being noted in low velocity incidents (LVKD), involving morbidly obese people
Summary
Traumatic knee dislocation (KD) is a serious and potentially limb threatening injury, albeit a relatively rare condition: the incidence has been reported as approximately 0.02-0.2% of orthopaedic injuries [1,2,3]. Knee dislocations (KD) often reduce spontaneously out with the emergency department, potentially leading to a high rate of delayed presentation or missed diagnosis [6, 7]. The same study found that obese patients with low energy knee dislocations were more likely to have neurovascular injuries requiring surgical intervention than patients with higher energy traumatic dislocations.
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