Traumatic knee dislocations: a national database analysis

BACKGROUND: Knee dislocation is a rare but severe orthopedic emergency with a substantial risk of limb-threatening complications. This retrospective national database cohort study aimed to describe the epidemiology of traumatic knee dislocations and identify risk factors for vascular and neurological injuries. METHODS: A total of 164 patients diagnosed with knee dislocation between 2016 and 2023 were included in this retrospective study. Data were obtained from the Ministry of Health system, and diagnoses were confirmed. Demographics, injury mechanisms, associated fractures, and complications were evaluated using International Classification of Diseases (ICD) codes. Logistic regression was used to identify independent risk factors. RESULTS: The study population consisted primarily of males (81.7%) with an average age of 31.74 years. Vascular injuries occurred in 19.5% of patients, most commonly involving the popliteal artery. Neurological injury was present in 20.1%. In patients with open injuries, infection, vascular injury, amputation, debridement, and soft tissue defect repair were found to be significantly higher. Despite these findings, open injury was not an independent predictor of vascular injury in multivariate analysis. Charlson Comorbidity Index (CCI) > 0 independently predicted the need for vascular procedures. Younger age was associated with neurological injury. Intensive Care Unit (ICU) admission was associated with systemic injuries. The overall amputation rate was 1.2%. CONCLUSION: Traumatic knee dislocations frequently involve serious neurovascular complications. While open injuries were associated with a more complicated clinical course, only CCI independently predicted the need for vascular intervention. Early recognition of patients with comorbidities and significant concomitant injuries may improve outcomes. LEVEL OF EVIDENCE: Level IV.