Treatment for Acute Knee Dislocations

Abstract

Acute knee dislocations, though uncommon, are among the most serious injuries encountered by the orthopedic surgeon. Many knee dislocations spontaneously reduce prior to presentation to the hospital; thus, a keen understanding of the characteristic injury mechanism and a high clinical suspicion are necessary to appropriately identify and treat this patient population. Once a knee dislocation is identified, the physical examination of the affected lower extremity is crucial to delineate the extent of the osseous and soft tissue injury, as well as prevent limb-threatening neurovascular complications. Appropriate diagnostic testing should assist in guiding immediate and delayed treatment. Neurovascular and open injuries should be addressed immediately, while fractures should be stabilized early in the post-dislocation period. There is no consensus regarding the most appropriate treatment for the multiligamentous injury that accompanies a knee dislocation. Injury pattern, patient-specific factors, and surgeon factors should all be considered when treating the ligamentous injuries associated with a knee dislocation. This chapter provides a comprehensive review of the literature alongside our current approach to the management of the acute knee dislocation and the associated multiligamentous knee injury.