Imaging Studies

Standard anteroposterior (AP) and lateral radiographs can be obtained to detect a knee dislocation (see the image below).^[16] After reduction, repeat AP and lateral radiographs are obtained to confirm reduction. Oblique views after reduction may delineate small avulsion or rim fractures and osteochondral fractures.^[17]

Knee dislocations. Lateral radiograph of anterior knee dislocation.

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With technological advances in Doppler imaging, the need for arteriography in postreduction limbs that have normal vascular examination findings is controversial.^[18] Some argue that unremarkable findings on Doppler obviate the need for arteriography, which is more expensive and is associated with a low but real risk of complications.^[19] The authors had a patient who was discharged home 2 days after initial unremarkable findings on arterial Doppler study and returned the next day with an acute occlusion of the popliteal artery from an intimal flap. The authors continue to strongly recommend routine arteriography in these cases.

For ligament injuries of the knee, magnetic resonance imaging (MRI) can be used to assess the extent and location of ligament disruption, meniscal tears, and subtle injuries to the bone, as well as to determine which tears are repairable.^{[20, 21]}

Treatment & Management

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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 Workup

Imaging Studies

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