What should I do if my knee is dislocated?

If you encounter the problem of knee dislocation, you still need to be careful in normal times. You need to understand clearly what to do in this situation and what methods to choose to deal with it. What you need to do in this situation is to speed up treatment and respond positively.

After a knee dislocation, closed reduction can often be used to achieve satisfactory reduction. Hematoma in the joint should be aspirated aseptically. Then, use thigh plaster to fix the knee joint at 15° to 20° flexion. This is a temporary and good treatment measure because it can prevent the knee joint from suffering further damage. The thigh is temporarily fixed with plaster for 5 to 7 days. During this time, a thoughtful and appropriate surgical plan to repair the ligament can be carefully selected. For example, if the knee joint is unstable after manual reduction, especially if the knee joint is dislocated posterolaterally, if the knee joint shows instability after reduction, it is often possible that other tissues are embedded in the middle of the joint. Brennan et al. believed that the medial femoral condyle might be embedded in the torn joint capsule, like a "button-like" incarceration, blocking the reduction of the knee joint.

Quinlan and Sharrard et al. found that torn collateral ligaments and pes anserine tendons can also block knee reduction. If a knee dislocation is difficult to reduce, a medial approach is often used to perform an incision and reduction.

The choice of surgical approach depends on the type of displacement direction of the knee dislocation. During surgery, people often feel confused about whether to repair damaged tissue or remove it, which is sometimes extremely difficult. Some cases, although repaired surgically, still have some symptoms similar to ligament injuries later. When repairing ligament injuries, it is best to do it as early as possible. Sisk and King reported that in the long-term follow-up, 88% of the patients who underwent early ligament repair achieved satisfactory results, while only 64% of those who underwent simple plaster fixation achieved satisfactory results. Therefore, surgical repair is recommended whenever possible, especially for injuries like the quadriceps femoris or other large complex injuries, where surgical results are far better than non-surgical methods. The non-surgical method is to first apply a thigh plaster cast and observe for 5 to 7 days. If there are no special circumstances, it will be maintained for 6 weeks.

In short, if surgical treatment is chosen to treat knee dislocation, the various torn tissues caused by damage to the medial, lateral, anterior or posterior structures of the knee joint due to dislocation must be repaired during the operation.

For cases of old knee dislocation and severe traumatic arthritis, joint compression fixation and fusion should be used. Damage to the common peroneal nerve is mostly due to excessive traction, which makes repair and suturing difficult. About 50% of cases leave permanent nerve paralysis.