Background

Traumatic knee dislocations are devastating injuries and there is no single best accepted treatment. Treatment needs to be customised to the patient taking into consideration injury to the knee; associated neurovascular and systemic injuries.

Objective

This study looked at functional outcome of a single surgeon case series of patients who underwent surgical management of their knee dislocation.

Methods

Seventy patients with knee dislocation were treated with multi-ligament reconstruction at a major trauma centre. Acute surgical repair and reconstruction with fracture fixation within 3 weeks was preferred unless the patient was too unstable (Injury severity score>16). PCL was primarily braced and reconstructed subsequently, if required. Outcome was collected prospectively using IKDC score, KOOS and Tegner score.

Results

The mean age of the patients was 35yrs (17–74), 53 males and 17 females. 5 patients had CPN injury (7%), 3 had vascular injury (4.2%), 2 had combined CPN and vascular injury (2.8%). Acute surgical treatment was done in 48 patients while 10 had staged reconstruction. 22 patients had delayed reconstruction. The mean follow-up period was 4.8 years (1–12 yrs). According to the IKDC score 67% of the patients had near-normal knee function. The mean Tegner activity scale postoperatively was 4.5 (preinjury 6.5) and the mean KOOS score was 75.3.

Four patients had stiffness and needed arthroscopic arthrolysis, two patients had a residual foot drop from the original injury and needed tendon transfer.

Conclusion

Traumatic knee dislocation is a challenging problem but good outcomes can be achieved by surgical management.