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Dislocation of the knee

What is Dislocation?

It is basically an injury to the joint, which causes the bones to be dislocated from their positions. It results in affecting the movement of the bones.

Cause of Dislocation:

Dislocation of the knee is a rare injury and is usually caused by high velocity trauma such as road traffic accident or a hit to the knee during sports or a fall.

However, the high risk group for dislocations include the following.

  • Patients who are susceptible to falls.
  • Patents with hereditary problem having loose ligaments and tissues.
  • Sportsperson, cops, military personnel and others with similar high activity profile.

knee Dislocation

Symptoms of Dislocation:

In most cases, the dislocated area will be swollen or look bruised red or discolored. It will also have a deformed shape caused due to the dislocation. Apart from this, the victim may suffer from loss of motion with acute severe pain. Numbness around the affected area or the distal aspect of the leg may be present because of stretching of the skin or injury to the nerve. In case of vascular injury the affected limb may look pale or discoloured.

Diagnosis of Dislocation:

After physical examination, the doctor asks for an X-Ray to confirm the dislocation and the amount of damage that has occurred. For more complex cases, the MRI scan is requested in order to know the extent of soft tissues damage around the affected joint. Sometimes special scans are necessary to know the status of the blood vessels. Knee dislocation usually occurs in a high velocity injury and so additional injuries should be looked for and carefully noted. Rupture of the ligaments and muscles are so common and should be taken care from the beginning to get maximum results. 

There are two types of dislocations. The Anterior and Posterior types. Picture illustrates the damage to surrounding tissues including ligaments and blood vessels.

dislocation-of-the-knee

Types of Knee Dislocation

Treatment for Joint Dislocation:

The doctor will take the call on the treatment depending upon the severity and intensity of the dislocation. However the initial treatment of dislocation involves rest, ice, compression or placing the knee in an elevated position. The definitive treatment then involve:

  • Repositioning the joint back to place should be performed as soon as possible to avoid permanent damage to neuro vascular structures and to ease the patient from the severe pain. The patient is given a sedative or anesthesia and the doctor then applies force to put things back to normal. After the doctor fixes the dislocation, he prescribes medicines for a certain course that would waive off the pain. The leg is placed in a protective plaster for two to three weeks, after which treatment for associated injuries (Ligament structure) is planned.

Surgeon manipulates the dislocated joint and brings it to normal position under anaesthesia.

  • Surgery is done for associated injuries. Depending on the extent of the injury the operative treatment is planned. Sometimes it may be a onetime procedure or at times additional procedures may be necessary. Usually important ligaments of the knee are damaged at the time of dislocation and they need to be reconstructed with patients own tissue (auto-graft)and if that is not enough then with grafts taken from other persons (allo-graft) or synthetic materials, to bring back stability to the knee.

Authored By Dr. Raj Kanna - Orthopaedic and Knee surgeon, Chennai

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