Multiple ligament injury, which means disruption of at least 3 of the 4 major ligaments, generally occurs due to high energy trauma. Knee dislocation usually leads to the multiple ligament injury, and the terms 'knee dislocation' and 'multiple ligament injury' are used interchangeably. In some cases, a dislocated knee may have been spontaneously reduced immediately after the trauma. This is the reason why we should consider the possibility of knee dislocation and carry out a thorough vascular and neurologic evaluation when a patient with multiple ligament injury presents to an emergency department. Multiple ligament injury, when not properly treated, may lead to instability of the knee joint, resulting in posttraumatic arthritis. Though treatment and rehabilitation of multiple ligament injury is difficult, we should pursue full recovery of the knee joint through precise examination and proper treatment. There is controversy about conservative vs. surgical treatment, early vs. delayed surgeory, and repair vs. reconstruction, but surgical treatment and early reconstruction are now preferred.
Arthritis ; Emergencies ; Humans ; Knee ; Knee Dislocation ; Knee Joint ; Ligaments

Multiple ligament injuries of the knee means more than two ligament injuries, using as an analogue of the knee dislocation. The first priority in the early diagnosis and treatment of the knee dislocation is a vascular evaluation of extremity and careful neurovascular examination should be done firstly. It is common opinion in the treatment of multiple ligament injuries that surgical treatment is superior to conservative treatment. Especially, early ligament repair or reconstruction and aggressive rehabilitation are recommended in young active patients.
Dislocations ; Early Diagnosis ; Extremities ; Humans ; Knee ; Knee Dislocation ; Ligaments

The lateral compression injury of the pelvis is common in high-speed vehicle accidents, and symphysis pubis disruption can occur with external rotation or anterior compression injury. The most common injury of the symphysis pubis is diastasis. So far, four cases of the locked symphysis pubis have been reported, and two of these were treated by closed reduction. The current case involves a 26-year-old man who experienced a lateral compression force to his pelvis and knees, and suffered a symphysis pubis disruption (locked symphysis pubis, i.e., creeping of the left pubic body below the right pubic body), urethral rupture and bilateral knee dislocation. The locked symphysis pubis was successfully reduced with a closed maneuver.
Adult ; Dislocations* ; Humans ; Knee ; Knee Dislocation ; Pelvis ; Rupture

From Nov. 1986 to May 1988, we experienced 5 patients of bilateral recurrent patellar dislocation and obtained the following results:1. The age at operation raaged from 17 to 25 years. Among 5 patients, four were female and one, male. 2. The age at the onset of symptom ranged from 7 to 16 years. 3. The common presenting symptoms were pain(5 knees), giving way(4), grating(4), swelling (3), and weakness(2). 4. The roentgenographic findings were lateral patella tilt(9 knees), lateral femoral condyle hypoplasia(6), patella alta(2), patella dysplasia(2), and accessory ossification center(2). 5. All knees were treated by Hughston technique:One patient(2 knees) was treated with proximal realignment only, and the others(7 knees) were with proximal and distal realignments. 6. Follow up period ranged from 1 to 2 years. And the excellent to good result was obtained from the patients treated with proximal and distal realignments(excellent in 4 knees, good in 2 knees), the fair result from the patient treated with proximal realignment only(2 knees), and the poor result from the patient slipped down at 6 weeks postoperatively(1 knee).
Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Patella ; Patellar Dislocation

It has been suggested that in the majority of patellar dislocation cases, the medial patellofemoral ligament (MPFL) is disrupted with a high recurrence rate especially in female patients. Although MPFL tear is not the primary cause of instability, MPFL reconstruction is effective for stabilizing the knee and may alone prevent lateral patellar dislocation. There is limited but growing evidence that MPFL reconstruction for patellofemoral instability leads to excellent functional outcomes. Growing awareness of the biomechanical contribution of the MPFL has led to an upsurge in the publication of techniques and trials dealing with reconstructive techniques, warranting a review that includes the most recent evidence. The aim of this article was to review and summarize the recent literatures concerning MPFL reconstruction and provide a comprehensive review of previous studies ranging from basic science to current surgical techniques and results.
Female ; Humans ; Knee ; Ligaments ; Patellar Dislocation ; Publications ; Recurrence ; Tears

BACKGROUND: The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance. METHODS: Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance. RESULTS: We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, 7.9° vs. −0.81°). CONCLUSIONS: Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.
Femur ; Humans ; Knee ; Osteotomy ; Patella ; Patellar Dislocation* ; Retrospective Studies

Adult ; Female ; Humans ; Knee Dislocation ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged

Knee dislocation is one of the rare orthopedic emergencies that require special management with an annual incidence rate of less than 0.02%. Knee dislocations are classified by Kennedy, according to the direction of tibial dislocation in relation to the femur, as anteromedial, posteromedial, anterolateral, and posterolateral. Operative intervention and multi-ligament reconstruction are usually required in knee dislocation. Interposition of the vastus medialis inside the joint of a dislocated knee is an uncommon scenario where reduction becomes impossible. In this report, we present a case of irreducible knee dislocation with vastus medialis muscle interposition. Before reduction, we performed arthroscopy of the knee and removal of the interposed muscle to prevent extravasation of the fluid by sealing the torn capsular area.
Arthroscopy ; Dislocations ; Emergencies ; Femur ; Incidence ; Joints ; Knee Dislocation ; Knee ; Orthopedics ; Quadriceps Muscle

PURPOSE: The aim of this study is to analyse the clinical characteristics and results of treatment of knee dislocation. MATERIALS AND METHODS: The 18 cases of the traumatic dislocation of knee were treated at Yeung-nam university hospital from 1991 Jan. to 1997 Apr. and those were followed more than one year after injury. Result: Anterior and posterior cruciate ligament were ruptured in all cases and the two thirds of the ruptured site of cruciate ligament was femoral attachment, Medial collateral ligament injury(13 cases) were more than lateral collateral injury(8 cases) and more than half cases of collateral ligament injury were rup- tured at tibial and fibular attachment. The functional result by Lysholm knee scoring revealed fair(81 score) in average and excellent in 3 cases, good in 5 cases, fair in 10 cases. Complications were limitation of motion in 6 cases, pain in 2 cases and nerve paraiysis in 1 case. CONCLUSION: Applying classification system according to direction of displacement is sometimes difficult because the dislocation of knee could be transferred after reduction. It was thought that another subclassifica- tion system in terms of ligaments involved should be used. Functional results by Lysholm knee scoring revealed fair(81 score) in average. Early range of motion should be started after surgical repair and minimal immobilization to avoid limitation of knee motion.
Classification ; Collateral Ligaments ; Dislocations* ; Immobilization ; Knee Dislocation ; Knee* ; Ligaments ; Posterior Cruciate Ligament ; Range of Motion, Articular

PURPOSE: The purpose of this study was to determine the effectiveness of a new two stage surgical treatment for acute traumatic knee dislocation. MATERIALS AND METHODS: The study involved 15 knees in 14 patients treated between October 1997 and November 2001. The mean follow-up period was 24 months. In the first surgical stage, medial and/or lateral ligament complexes were repaired or reconstructed within two weeks of the injury. In the second surgical stage, once full range of motion was obtained 3-6 months later, anterior or posterior cruciate ligaments (ACL or PCL) were reconstructed if significant laxity was present. The final outcomes were assessed using stress X-rays, range of motion and Lysholm score. RESULTS: There were ten cases of MCL tear and eight cases of LCL tear. All MCL and LCL injuries were either repaired or reconstructed. All cases had both ACL and PCL tears. Following the first stage of MCL/LCL surgery, the second stage surgery of ACL or PCL reconstructions was deemed to be necessary in three and seven cases, respectively. Five cases did not require ACL or PCL reconstruction. In stress X-rays at the last follow up examination, MCL, LCL, ACL and PCL instability was graded as 0 or 1 in 15, 14, 15 and 11 cases, respectively. PCL instability was graded as 2 in four cases. The mean postoperative Lysholm score was 87.6 points. CONCLUSION: The two stage surgical approach described here resulted in good outcomes for patients suffering from acute knee dislocation patients in terms of range of motion and stability.
Collateral Ligaments ; Follow-Up Studies ; Humans ; Knee Dislocation* ; Knee* ; Posterior Cruciate Ligament ; Range of Motion, Articular