Korean J Sports Med.  2012 Jun;30(1):1-8. 10.5763/kjsm.2012.30.1.1.

The Management of Knee Dislocation and Multiple Ligament Injuries

• Kim KM
• Chun CH

• KMID: 2288642
• DOI: http://doi.org/10.5763/kjsm.2012.30.1.1

Abstract

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.

Keyword

Knee; Dislocation; Multiple ligament injuries

MeSH Terms

Dislocations
Early Diagnosis
Extremities
Humans
Knee
Knee Dislocation
Ligaments

Figure

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  Fig. 1 (A) Anterior dislocation. (B) Posterior dislocation.

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  Fig. 2 (A) The arteriogram showed complete popliteal artery occlusion. (B) Bypass graft using contra-lateral saphenous vein and four-compartment fasciotomy was performed immediately.

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  Fig. 3 Exploration of peroneal nerve (arrow, peroneal nerve).

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  Fig. 4 Time of surgery in multi-ligament injury of knee. ACL: anterior cruciate ligament, PCL: posterior cruciate ligament, MCL: medial collateral ligament.

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  Fig. 5 Arthroscopic assisted simultaneously anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction in the knee dislocation. (A, B) Guide pin for PCL reconstruction at tibial and femoral site. (C) Reaming tibial tunnel under image intensifier. (D) Guide wire for PCL and guide pin for ACL reconstruction. (E) Insert PCL allograft. (F) Insert ACL allograft. (G, H) Postoperative X-ray.

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  Fig. 6 A 45-year-old male patient was injured during foot ball game who had anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and grade II medial collateral ligament (MCL) injury. Operation was done at 21 days after trauma. (A) MRI image of grade II MCL injury. (B) MRI image of ACL injury. (C) MRI image of PCL injury. (D) Arthroscopic findings of ACL and PCL reconstruction state use 2 achilles tendon allografts. (E) Postoperative X-ray.

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  Fig. 7 A 28-year-old male patient was injured with out car accident who had anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and posterolateral corner injury with knee dislocation. Operation was done at 10 days after trauma. (A) Preoperative X-ray. (B) MRI image of ACL injury. (C) MRI image of PCL injury. (D) MRI image of Posterolateral corner injury. (E) Arthroscopic findings of ACL and PCL reconstruction state used 2 achilles tendon allografts. (F) Operation used an achilles tendon allograft. Graft runs from anterior to posterior through the tunnel in the fibula. (G) Intra-operative findings of Posterolateral coner injury. Fixed graft at femoral tunnel site. (H) Postoperative X-ray.

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