This document discusses dislocation of the knee. It provides information on the surgical anatomy of the knee including osseous, extraarticular, and intraarticular structures that provide stability. Traumatic knee dislocations are described as being relatively uncommon but can cause devastating complications like damage to the popliteal artery in around 20% of cases. Knee dislocations are classified based on factors like if they are open or closed. Examination and imaging are important to evaluate the injury and direction of dislocation. The sequence of surgery and rehabilitation are also outlined.

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%

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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…