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Knee dislocations are high energy traumatic injuries characterized by a high rate of neurovascular injury Patellar dislocations and procedural sedation for the performance of joint reduction is discussed separately. Diagnosis is made clinically with careful assessment of limb neurovascular status
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Radiographs should be obtained to document reduction. This topic will review the mechanisms and management of acute tibiofemoral dislocations 50% of knee dislocations will spontaneously reduce before ed arrival
Suspect dislocation in patients with significant joint swelling and laxity
After reduction, always check abis or duplex ultrasound Consult vascular surgery early if there is suspicion for an arterial injury. Successful reduction is preliminarily confirmed by visible restoration of a normal knee contour and by decreased pain Immediately immobilize the knee in full extension with a knee immobilizer or splint (1, 2)
The immobilizer should be worn for 3 weeks This patient's knee was dislocated during a motor vehicle accident In this video the reduction of the dislocated knee is demonstrated.more Even dislocations that spontaneously reduce before evaluation by a healthcare professional carry the risk of significant neurovascular injury
Controversies in the treatment of knee dislocations and multiligament reconstruction
J am acad orthop surg Modifications to this guideline may be necessary dependent on physician specific instruction, specific tissue healing timeline, chronicity of injury and other contributing impairments that need to be addressed. Reduce the knee as soon as possible if dislocated Document pulses before and after!
Prehospital personnel should splint the extremity and provide rapid transport to a medical facility Perform field reduction for patients with evidence of vascular compromise Immediate reduction followed by careful neurovascular assessment is necessary
