Traumatic knee dislocations: immediate interventions and long-term outcomes

Abdullah F. Aborukbah; Faris M. Anbarserri; Maha K. Almutairi; Hisham A. Elbashir; Sulaiman M. Aldawood; Azzam S. Aljabri; Mohammed J. Almunaikh; Mazen L. Alhejaili; Mohammed A. Aljohani; Ahmad H. Bedaiwi; Ammar J. Almutairi

doi:10.18203/2394-6040.ijcmph20244062

Authors

Abdullah F. Aborukbah Department of Orthopedics, Al Thager Hospital, Jeddah, Saudi Arabia
Faris M. Anbarserri College of Medicine, Charles University, Pilsen, Czechia
Maha K. Almutairi College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Hisham A. Elbashir Department of Orthopaedics, Nottingham University Hospital, Nottingham, United Kingdom
Sulaiman M. Aldawood Department of Emergency Medicine, King Faisal General Hospital, Mecca, Saudi Arabia
Azzam S. Aljabri Department of Emergency Medicine, Ajyad Emergency Hospital, Mecca, Saudi Arabia
Mohammed J. Almunaikh Department of Orthopaedics, McMaster University, Kingston, Canada
Mazen L. Alhejaili College of Medicine, Al Rayan Colleges, Medina, Saudi Arabia
Mohammed A. Aljohani College of Medicine, Al Rayan Colleges, Medina, Saudi Arabia
Ahmad H. Bedaiwi College of Medicine, Al Rayan Colleges, Medina, Saudi Arabia
Ammar J. Almutairi College of Medicine, Al Rayan Colleges, Medina, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20244062

Keywords:

Knee dislocations, Traumatic injury, Reduction techniques, Rehabilitation, Long-term outcomes

Abstract

Traumatic knee dislocations are severe orthopedic injuries that result from high-energy trauma and involve complete disruption of the tibiofemoral joint. These injuries are rare but represent a significant clinical challenge due to the risk of associated vascular, nerve, and soft tissue damage. Early diagnosis and timely intervention are critical for reducing the risk of permanent disability. The immediate management involves a comprehensive assessment, including history, physical examination, and imaging, followed by the restoration of joint alignment through reduction techniques. Proper management of associated vascular injuries, particularly popliteal artery damage, and nerve injuries, such as peroneal nerve damage, is crucial to prevent long-term complications. Following reduction, knee stabilization and immobilization are necessary to promote healing. Long-term outcomes can be challenging, with complications such as joint instability, post-traumatic arthritis, chronic pain, and the potential for recurrent dislocations. Rehabilitation, which includes range of motion exercises, strength training, and proprioceptive training, plays a vital role in restoring function. In some cases, surgical intervention, including ligament reconstruction or total knee arthroplasty, may be required. This review examines the immediate interventions for traumatic knee dislocations, the associated complications, and long-term outcomes, highlighting the importance of a multidisciplinary approach for optimal recovery and functional restoration.

Metrics

Metrics Loading ...

References

Teissier V, Tresson P, Gaudric J, Davaine JM, Scemama C, Raux M, et al. Importance of Early Diagnosis and Care in Knee Dislocations Associated with Vascular Injuries. Ann Vasc Surg. 2019;61:238-45.

Stannard JP, Schenck R, Fanelli GC, Bucholz R, Heckman J, Tornetta P. Knee dislocations and fracture-dislocations. Bucholz RW, Heckman JD, Court-Brown CM, Tornetta P, editors. Rockwood and Green’s fractures in adults 7th ed Philadelphia: Lippincott Williams & Wilkins. 2009;1832-66.

Brautigan B, Johnson DL. The epidemiology of knee dislocations. Clin Sports Med. 2000;19(3):387-97.

Boyce RH, Singh K, Obremskey WT. Acute management of traumatic knee dislocations for the generalist. J Am Acad Orthop Surg. 2015;23(12):761-8.

Schenck Jr R. Classification of knee dislocations. Oper Tech Sport Med. 2003;11(3):193-8.

Good L, Johnson RJ. The dislocated knee. J Am Acad Orthop Surg. 1995;3(5):284-92.

Walker RE, McDougall D, Patel S, Grant JA, Longino PD, Mohtadi NG. Radiologic review of knee dislocation: from diagnosis to repair. Am J Roentgenol. 2013;201(3):483-95.

Dawson-Amoah K, Raszewski J, Duplantier N, Waddell BS. Dislocation of the hip: a review of types, causes, and treatment. Ochsner J. 2018;18(3):242-52.

Henrichs A. A review of knee dislocations. J Athl Train. 2004;39(4):365.

Held M, Laubscher M, Von Bormann R, Walters J, Roche S, Banderker A, et al. High rate of popliteal artery injuries and limb loss in 96 knee dislocations. SA Orthop J. 2016;15(1):72-6.

Frassica FJ, Sim FH, Staeheli JW, Pairolero PC. Dislocation of the knee. Clin Orthop Relat Res. 1991;263:200-5.

Cush G, Irgit K. Drop foot after knee dislocation: evaluation and treatment. Sports Med Arthrosc Rev. 2011;19(2):139-46.

Baird MB, Shasteen M, Nelson V. Knee Immobilization for Acute Knee Injuries: A Review. J Urgent Care Med. 2022;16(8):13-9.

Plancher KD, Siliski J. Long-term functional results and complications in patients with knee dislocations. J Knee Surg. 2008;21(04):261-8.

Harner CD, Waltrip RL, Bennett CH, Francis KA, Cole B, Irrgang JJ. Surgical management of knee dislocations. JBJS. 2004;86(2):262-73.

Jerosch J, Prymka M. Proprioception and joint stability. Knee Surg Sport Traumatol Arthrosc. 1996;4(3):171-9.

Hilber F, Pfeifer C, Memmel C, Zellner J, Angele P, Nerlich M, et al. Early functional rehabilitation after patellar dislocation-What procedures are daily routine in orthopedic surgery? Injury. 2019;50(3):752-7.

Salonen EE, Magga T, Sillanpää PJ, Kiekara T, Mäenpää H, Mattila VM. Traumatic patellar dislocation and cartilage injury: a follow-up study of long-term cartilage deterioration. Am J Sport Med. 2017;45(6):1376-82.

Medina O, Arom GA, Yeranosian MG, Petrigliano FA, McAllister DR. Vascular and nerve injury after knee dislocation: a systematic review. Clin Orthop Relat Res. 2014;472(9):2621-9.

Gray JL. Management of Arterial and Venous Injuries in the Dislocated Knee John L. Gray and Matt Cindric. The Multiple Ligament Injured Knee: A Practical Guide to Management. 2012;331.

Hegyes MS, Richardson MW, Miller MD. Knee dislocation: complications of nonoperative and operative management. Clin Sport Med. 2000;19(3):519-43.

Bedi A, Haidukewych GJ. Management of the posttraumatic arthritic knee. J Am Acad Orthop Surg. 2009;17(2):88-101.