Initial Treatment of Knee Traumatic Dislocation (A Cross-Sectional Study (

Baniasadi, Mojtaba; Hadian, Mehdi; Rostami, Mohammad; Assadi, Alirza; Rahmani, Shahryar

doi:10.22034/ijos.2025.243325

Initial Treatment of Knee Traumatic Dislocation (A Cross-Sectional Study (

Document Type : Original Article

Authors

mojtaba baniasadi ¹

mehdi hadian ¹

mohammad rostami ²

Alirza Assadi ³

shahryar rahmani ⁴

¹ Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

² , School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

³ School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

⁴ Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

10.22034/ijos.2025.243325

Abstract

Abstract
Introduction: Knee dislocation has potential for complex injury to blood vessels nerves and ligaments. It requires prompt diagnosis and treatment. Radiological assessments aid in guiding appropriate orthopedic and surgical interventions. This study aims to assess the treatment outcomes of knee dislocations.
Materials & Methods: A cross-sectional study of patients admitted to an orthopedic center within 4 years with knee dislocation was conducted. Demographic data, initial treatments, correlated injuries, pain severity, and post-surgery outcomes were collected. The initial management which was with external fixation or bracing were conquered. Statistical analysis was performed using SPSS v25.
Results & Discussion: Sixty-two patients (11 female, 51 male) were enrolled. Motor vehicle accident, car accident, and falls were common causes. Co-occurring injuries included ligamentous, vascular, and nerve injuries, with the first one being predominant. The initial treatments were by either bracing or external fixation. No re-dislocation was reported in the external fixator group, while 5 occurred in the bracing group. Pain severity scores were lower in the external fixator group at 1 and 3 months post-surgery. Time to return to work and duration of rehabilitation were, non-significantly, shorter in brace treatment group.
Conclusion: Both brace and external fixator show promise as initial knee dislocation treatments, offering distinct benefits. Definitive conclusions warrant comprehensive clinical trials.

Keywords

Knee Dislocation

Treatment outcome

Knee

Joint Dislocations

Subjects

Knee

1. Anazor FC, Baryeh K, Davies NC. Knee joint dislocation: overview and current concepts. Br J Hosp Med (Lond). 2021 Dec 2; 82(12): 1-10. doi: 10.12968/hmed.2021.0466. Epub 2021 Dec 28. PMID: 34983230.

2. Fanelli GC. Knee Dislocation and Multiple Ligament Injuries of the Knee. Sports Med Arthrosc Rev. 2018 Dec; 26(4): 150-152. doi: 10.1097/JSA.0000000000000220. PMID: 30395055.

3. Mohseni M, Mabrouk A, Simon LV. Knee dislocation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Nov 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470595/

4. 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 Sep; 472(9): 2621-9. doi: 10.1007/s11999-014-3511-3. PMID: 24554457; PMCID: PMC4117866.

5. Niall DM, Nutton RW, Keating JF. Palsy of the common peroneal nerve after traumatic dislocation of the knee. J Bone Joint Surg Br. 2005 May; 87(5): 664-7. doi: 10.1302/0301-620X.87B5.15607. PMID: 15855368.

6. Peskun CJ, Whelan DB. Outcomes of operative and nonoperative treatment of multiligament knee injuries: an evidence-based review. Sports Med Arthrosc Rev. 2011 Jun; 19(2): 167-73. doi: 10.1097/JSA.0b013e3182107d5f. PMID: 21540715.

7. Levy BA, Krych AJ, Shah JP, Morgan JA, Stuart MJ. Staged protocol for initial management of the dislocated knee. Knee Surg Sports Traumatol Arthrosc. 2010 Dec; 18(12): 1630-7. doi: 10.1007/s00167-010-1209-y. Epub 2010 Jul 16. PMID: 20635077.

8. Fanelli GC. Multiple Ligament Injured Knee: Initial Assessment and Treatment. Clin Sports Med. 2019 Apr; 38(2): 193-198. doi: 10.1016/j.csm.2018.11.004. Epub 2019 Jan 19. PMID: 30878043.

9. Peskun CJ, Levy BA, Fanelli GC, Stannard JP, Stuart MJ, MacDonald PB, Marx RG, Boyd JL, Whelan DB. Diagnosis and management of knee dislocations. Phys Sportsmed. 2010 Dec; 38(4): 101-11. doi: 10.3810/psm.2010.12.1832. PMID: 21150149.

10. Hegyes MS, Richardson MW, Miller MD. Knee dislocation. Complications of nonoperative and operative management. Clin Sports Med. 2000 Jul; 19(3): 519-43. doi: 10.1016/s0278-5919(05)70222-2. PMID: 10918964.

11. Murphy CI, Roessler PP, Lawyer TJ, Musahl V. Acute knee dislocations. In: Margheritini F, Espregueira-Mendes J, Gobbi A, editors. Complex knee ligament injuries. Berlin, Heidelberg: Springer; 2019. p. 123-13. doi: 10.1007/978-3-662-58245-9_11

12. Sillanpää PJ, Kannus P, Niemi ST, Rolf C, Felländer-Tsai L, Mattila VM. Incidence of knee dislocation and concomitant vascular injury requiring surgery: a nationwide study. J Trauma Acute Care Surg. 2014 Mar; 76(3): 715-9. doi: 10.1097/TA.0000000000000136. PMID: 24553539.

13. Edwards GA, Sarasin SM, Davies AP. Dislocation of the knee: an epidemic in waiting? J Emerg Med. 2013 Jan; 44(1): 68-71. doi: 10.1016/j.jemermed.2011.06.064. Epub 2011 Nov 6. PMID: 22056550.

14. Pace A, Fergusson C. Spontaneous non-traumatic dislocation of the knee. Acta Orthop Belg. 2004 Oct; 70(5): 498-501. PMID: 15587043.

15. 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 May; 13(4): 313-6. doi: 10.1007/s00167-004-0520-x. Epub 2004 Oct 1. PMID: 15875163.

16. Shetty RR, Mostofi SB, Housden PL. Knee dislocation of a morbidly obese patient: a case report. J Orthop Surg (Hong Kong). 2005 Apr; 13(1): 76-8. doi: 10.1177/230949900501300114. PMID: 15872406.

17. Eranki V, Begg C, Wallace B. Outcomes of operatively treated acute knee dislocations. Open Orthop J. 2010 Jan 19; 4: 22-30. doi: 10.2174/1874325001004010022. PMID: 20224661; PMCID: PMC2836735.

18. Ríos A, Villa A, Fahandezh H, de José C, Vaquero J. Results after treatment of traumatic knee dislocations: a report of 26 cases. J Trauma. 2003 Sep; 55(3): 489-94. doi: 10.1097/01.TA.0000043921.09208.76. PMID: 14501892.

19. Talbot M, Berry G, Fernandes J, Ranger P. Knee dislocations: experience at the Hôpital du Sacré-Coeur de Montréal. Can J Surg. 2004 Feb; 47(1): 20-4. PMID: 14997920; PMCID: PMC3211817.

20. Harner CD, Waltrip RL, Bennett CH, Francis KA, Cole B, Irrgang JJ. Surgical management of knee dislocations. J Bone Joint Surg Am. 2004 Feb; 86(2): 262-73. doi: 10.2106/00004623-200402000-00008. PMID: 14960670.

21. King JJ 3rd, Cerynik DL, Blair JA, Harding SP, Tom JA. Surgical outcomes after traumatic open knee dislocation. Knee Surg Sports Traumatol Arthrosc. 2009 Sep; 17(9): 1027-32. doi: 10.1007/s00167-009-0721-4. Epub 2009 Feb 10. PMID: 19205664.

22. Ríos A, Villa A, Fahandezh H, de José C, Vaquero J. Results after treatment of traumatic knee dislocations: a report of 26 cases. J Trauma. 2003 Sep; 55(3): 489-94. doi: 10.1097/01.TA.0000043921.09208.76. PMID: 14501892.

23. Twaddle BC, Bidwell TA, Chapman JR. Knee dislocations: where are the lesions? A prospective evaluation of surgical findings in 63 cases. J Orthop Trauma. 2003 Mar; 17(3): 198-202. doi: 10.1097/00005131-200303000-00008. PMID: 12621261.

24. Parrado RH, Notrica DM. Vascular and Neurological Injury in Children With Posterior Traumatic Knee Dislocation. Am Surg. 2023 Jun; 89(6): 2791-2793. doi: 10.1177/00031348211050589. Epub 2021 Nov 6. PMID: 34747225.