Dislocation of the knee

The complications of knee dislocations may be disastrous and must be anticipated. In most series, a 25 to 30 per cent incidence of arterial damage is reported. If the artery is not repaired, the incidence of amputation can be up to 72.5 per cent. The popliteal artery should be evaluated and vascular repair performed as needed. This must be completed within a 6 to 8-hour period after injury for optimal results. Peroneal nerve injuries are common, and permanent neurologic damage may result. The neurovascular injury should be well documented both at the time of injury and in the preinjury state. After all problems affecting limb survival are solved, open repair of all ligamentous injuries is recommended to provide ligamentous stability and congruity of the joint. Prior to performing the procedure, a surgeon must have a thorough knowledge of the anatomy of the knee. Rehabilitation techniques and early postoperative motion are important for guiding the injured patient through the immediate and late postoperative period.