J Knee Surg 2020; 33(04): 335-338
DOI: 10.1055/s-0039-1700573
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Timing of Repair or Reconstruction after Knee Dislocation

Gregory C. Fanelli
1   Department of Sports Medicine and Orthopaedics, Geisinger Health System, Danville, Pennsylvania
› Author Affiliations
Further Information

Publication History

05 September 2019

17 September 2019

Publication Date:
04 November 2019 (online)

Abstract

The multiple ligament injured knee (knee dislocation) is, often times, part of a multisystem injury complex that can include not only injuries to knee ligaments but also to blood vessels, skin, nerves, bones (fractures), head injuries, and other organ system trauma. These additional injuries can affect surgical timing for knee ligament reconstruction and also affect the results of the treatment. This article will present the author's approach and experience in the initial assessment and treatment of the acute multiple ligament injured (dislocated) knee, and also present considerations in the treatment of chronic multiple ligament injured knee.

 
  • References

  • 1 Fanelli GC, Orcutt DR, Edson CJ. The multiple-ligament injured knee: evaluation, treatment, and results. Arthroscopy 2005; 21 (04) 471-486
  • 2 Mook WR, Miller MD, Diduch DR, Hertel J, Boachie-Adjei Y, Hart JM. Multiple-ligament knee injuries: a systematic review of the timing of operative intervention and postoperative rehabilitation. J Bone Joint Surg Am 2009; 91 (12) 2946-2957
  • 3 Levy BA, Dajani KA, Whelan DB. , et al. Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy 2009; 25 (04) 430-438
  • 4 Levy BA, Fanelli GC, Whelan DB. , et al; Knee Dislocation Study Group. Controversies in the treatment of knee dislocations and multiligament reconstruction. J Am Acad Orthop Surg 2009; 17 (04) 197-206
  • 5 Fanelli GC, Stannard JP, Stuart MJ. , et al. Management of complex knee ligament injuries. J Bone Joint Surg Am 2010; 92 (12) 2235-2246
  • 6 Fanelli GC, Feldman DD. Management of combined anterior cruciate ligament/posterior cruciate ligament/posterolateral complex injuries of the knee. Oper Tech Sports Med 1999; 7 (03) 143-149
  • 7 Fanelli GC, Harris JD. Late MCL (medial collateral ligament) reconstruction. Tech Knee Surg 2007; 6 (02) 99-105
  • 8 Fanelli GC, Harris JD. Surgical treatment of acute medial collateral ligament and posteromedial corner injuries of the knee. Sports Med Arthrosc Rev 2006; 14 (02) 78-83
  • 9 Fanelli GC, Giannotti BF, Edson CJ. The posterior cruciate ligament arthroscopic evaluation and treatment. Arthroscopy 1994; 10 (06) 673-688
  • 10 Fanelli GC. , ed. Arthroscopic evaluation of the PCL. In: Posterior Cruciate Ligament Injuries. A Practical Guide to Management. New York: Springer-Verlag; 2001: 95-105
  • 11 LaPrade RF. Arthroscopic evaluation of the lateral compartment of knees with grade 3 posterolateral knee complex injuries. Am J Sports Med 1997; 25 (05) 596-602
  • 12 Green NE, Allen BL. Vascular injuries associated with dislocation of the knee. J Bone Joint Surg Am 1977; 59 (02) 236-239
  • 13 Welling RE, Kakkasseril J, Cranley JJ. Complete dislocations of the knee with popliteal vascular injury. J Trauma 1981; 21 (06) 450-453
  • 14 Wascher DC, Dvirnak PC, DeCoster TA. Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma 1997; 11 (07) 525-529
  • 15 Kennedy JC. Complete dislocations of the knee joint. J Bone Joint Surg Am 1963; 45: 889-904
  • 16 Mills WJ, Barei DP, McNair P. The value of the ankle-brachial index for diagnosing arterial injury after knee dislocation: a prospective study. J Trauma 2004; 56 (06) 1261-1265
  • 17 Wascher DC. High-velocity knee dislocation with vascular injury. Treatment principles. Clin Sports Med 2000; 19 (03) 457-477
  • 18 Mavili E, Dönmez H, Kahriman G, Özaşlamacı A, Özcan N, Taşdemir K. Popliteal artery branching patterns detected by digital subtraction angiography. Diagn Interv Radiol 2011; 17 (01) 80-83
  • 19 Butt U, Samuel R, Sahu A, Butt IS, Johnson DS, Turner PG. Arterial injury in total knee arthroplasty. J Arthroplasty 2010; 25 (08) 1311-1318
  • 20 Kim D, Orron DE, Skillman JJ. Surgical significance of popliteal arterial variants. A unified angiographic classification. Ann Surg 1989; 210 (06) 776-781
  • 21 Keser S, Savranlar A, Bayar A, Ulukent SC, Ozer T, Tuncay I. Anatomic localization of the popliteal artery at the level of the knee joint: a magnetic resonance imaging study. Arthroscopy 2006; 22 (06) 656-659
  • 22 Alejandro SF, Maloney PJ, Cush GJ. Tendon transfers for peroneal nerve injuries in the multiple ligament injured knee. In: Fanelli GC. , ed. The Multiple Ligament Injured Knee. A Practical Guide to Management, 3rd ed. Switzerland: Springer Nature Switzerland AG; 2019: 357-367
  • 23 Stuart MJ. Evaluation and treatment principles of knee dislocations. Oper Tech Sports Med 2001; 9 (02) 91-95
  • 24 Stannard JP, Nuelle CW, McGwin G, Volgas DA. Hinged external fixation in the treatment of knee dislocations: a prospective randomized study. J Bone Joint Surg Am 2014; 96 (03) 184-191