History and Physical Examination

In isolated knee dislocations, patients are usually able to describe the mechanism of injury and the intense pain associated with dislocation. Since many of these injuries are high-energy motor vehicle collisions, evaluation for life-threatening injuries is the first priority.^[14]

In the secondary survey, evaluation of the limb usually reveals an obvious deformity of the knee. The appearance of knee dislocations may be less dramatic in individuals who are obese. The limb should be examined thoroughly for pulses, capillary refill, sensation, and motor strength. Vascular compromise may present as a stocking-glove type distribution of hypesthesia or anesthesia, decreased capillary refill, cyanosis, and poikilothermia.^[15] Distal pulses may be absent, and an expanding hematoma, bruit, or thrill may be present in the popliteal fossa.

Workup

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Media Gallery

Knee dislocations. Lateral radiograph of anterior knee dislocation.
Knee dislocations. MRI showing significant disruption medially and laterally with tibial bone bruise.
Knee dislocations. Examination under anesthesia revealing recurvatum and lateral ecchymosis.

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Author

John R Green III, MD Associate Professor, Department of Orthopaedics and Sports Medicine, Chief of Sports Medicine, University of Washington Medical Center

John R Green III, MD is a member of the following medical societies: American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, Southern Medical Association, Southern Orthopaedic Association, Washington State Medical Association, American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American College of Surgeons

Disclosure: Received educational program support from Pacific Medical for none.

Coauthor(s)

Cambize Shahrdar, MD Gratis Professor, Department of Orthopedic Surgery, Louisiana State University School of Medicine in Shreveport; Consulting Surgeon, Department of Orthopedic Surgery, The Orthopedic Clinic

Cambize Shahrdar, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Hip and Knee Surgeons

Disclosure: Nothing to disclose.

Brett D Owens, MD Director, Sports Medicine Research Lab, Director, Sports Medicine, Department of Orthopedics, The Miriam Hospital, The Warren Alpert Medical School of Brown University; Partner, Director, Cartilage Research Lab, University Orthopedics, Inc; Professor, Department of Orthopedic Surgery, The Warren Alpert Medical School of Brown University; Professor, Department of Epidemiology, Brown University School of Public Health; Professor, Department of Surgery, F Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences

Brett D Owens, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, American Shoulder and Elbow Surgeons, Arthroscopy Association of North America, Herodicus Society, Magellan Society - Orthopaedic Research and Education Foundation, Orthopaedic Trauma Association, Society of Military Orthopaedic Surgeons

Disclosure: Received consulting fee from Musculoskeletal Transplant Foundation/CONMED for consulting; Received consulting fee from Johnson & Johnson (MITEK) for consulting; Received royalty from Elsevier, SLACK Publishing, and Springer for other; Received salary from American Journal of Sports Medicine for employment.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Thomas M DeBerardino, MD, FAAOS, FAOA Professor of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, Joe R and Teresa Lozano Long School of Medicine; Professor of Orthopaedic Surgery and Faculty of Sports Medicine Fellowship, Baylor College of Medicine; Sports Medicine Orthopaedic Surgeon, Department of Orthopaedics, UT Health San Antonio; Consulting Surgeon, Sports Medicine, Arthroscopy and Reconstruction of the Knee, Hip and Shoulder

Thomas M DeBerardino, MD, FAAOS, FAOA is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, Clinical Orthopaedic Society, Herodicus Society, International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Arthrex, Inc.; MTF; Aesculap; Conmed; JRF<br/>Received research grant from: Arthrex, Inc.; MTF.

Acknowledgements

The authors and editors would like to acknowledge Margaret L Olmedo, MD, for the contributions made to this article.

Knee Dislocation Surgery Clinical Presentation

History and Physical Examination

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