knee dislocation, a major joint of lower limb for medical students

1. Dislocation of
Knee
Dr. Prasanna .C,
Prof. of Orthopaedics,
KMCHIHSR

2. 2
Surgical anatomy
• It is a complex compound synovial joint
• Superficial except posterior
• Knee stability - Osseous structures
Extraarticular structures, &
Intraarticular structures

3. Osseous structures
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4. Extraarticular structures
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5. Extraarticular structures
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6. Extraarticular structures
• popliteus muscle
• arcuate ligament
• prime medial rotator
• withdraw L meniscus
• rotary stability to
femur
• preventing forward
dislocation + PCL
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7. Intraarticular structures
• Medial and Lateral
Menisci
distribution of joint fluid,
nutrition, shock
absorption, deepening
of the joint,
stabilization of the
joint, and a load
bearing or weight
bearing
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8. Intraarticular structures
• Cruciate ligaments
restrict the backward and
forward motion of the
tibia
assist control of both medial
and lateral rotation
cruciate and collateral
ligaments exercise basic
antagonistic function
during rotation
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9. 9
Traumatic Dislocations
• Young adults & athletic activities
• Relatively uncommon
• Spontaneous reduction
• Diagnosis obvious except obese, polytrauma
• Devastating complications
Poplitial artery ~20%

10. 10
Classification
• Open or closed
• velocity - high, low or ultra low
• Reducible or irreducible
• Position of the tibia (anterior, posterior,
medial, lateral or rotary)

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Examination
• Deformity, pain, and swelling
• Completion and documentation of a
thorough neurovascular examination are
mandatory at initial evaluation, before
reduction and after reduction
• Tests for ligamentous laxity attempted
• Extensor mechanism
• Compartment syndrome

12. Radiographic Evaluation
• Anteroposterior,
lateral and oblique
views - direction of
dislocation & bony
injuries
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13. 13
Radiographic Evaluation
• MRI
actual site cruciate and
collateral ligament
injury, meniscal
disorders or injuries,
and status of the
popliteal tendon

14. 14
Sequence of Surgery for
Traumatic Knee Dislocation
• Examination under anesthesia (EUA)
• Arthroscopic examination
• Treatment of meniscal and osteochondral injuries
• Reconstruction of cruciate ligaments
• Repair, augmentation, reconstruction of collateral
ligaments
• ROM and EUA to ensure proper fixation
• Radiographic confirmation

15. Rehabilitation
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16. THANK YOU…