Dislocation occurs when one or more bones of the knee move out of their normal alignment, either partially or completely.
Dislocation of the knee results in immediate and acute pain that, typically, worsens with movement. This pain is accompanied by swelling and bruising at the site of injury, though damage to the popliteal artery, which supplies blood to the knee joint, can cause the skin to appear cold and pale. In this case, you should seek medical treatment immediately.
Damage to the ligaments and tendons of the joint can cause a popping or tearing sensation at the time of injury, while damage to the peroneal nerve, or other proximal nerves, can result in a radiating numbness or tingling sensation.
Knee dislocation typically results from high-impact trauma, such as that experienced during falls, contact sports or motor vehicle accidents. Acute twisting movements engaging the knee may also result in dislocation.
Individuals who have suffered historic knee injury, or who have been diagnosed with a condition which can weaken the ligaments of the knee, are at increased risk of dislocation, even from low-impact trauma. Overweight or obesity can also increase the stresses on the knee during acute twisting or fall.
Non-surgical treatment is typically only employed in the case of very simple dislocation, or where individual health factors preclude surgical intervention.
Reduction: closed reduction, involving the use of traction and manipulation to relocate the bones of the knee back in their correct anatomical position. This is often done as an emergency procedure and may be completed with or without anaesthesia.
Bracing or casting: following reduction, a brace or cast can be used to immobilise the joint during healing.
Rest and anti-inflammatory medications can be used to support the recovery process, while physiotherapy can help to restore functionality following dislocation.
Surgical intervention is often neccessary in instances of dislocation, since the causal injury often results in damage to the anciliary blood vessels, ligaments and nerves of the knee.
Open reduction and fixation: involves accessing the injured joint directly in order to repair any associated fractures, typically with plates and screws. An external fixator may be used in place of internal fixation where required.
Knee arthroplasty: Total or partial knee replacement, involving the fitting of artficial components in place of damaged parts of the joint, can be neccessary where the knee is irreperably damaged by the dislocation or by the causal injury.
Grafting: involves the use of graft bone from elsewhere in the patient’s body (autograft) or from a donor (allograft) to fill gaps and reinforce damaged areas.
Knee arthroscopy: a minimally-invasive procedure which allows direct access to the joint for repair or debris removal. For more information about knee arthroscopy and what you can expect from the procedure, visit our knee arthroscopy page.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
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Professor Dr Munjed Al Muderis is an orthopaedic surgeon specialising in osseointegration, hip, knee and trauma surgery. He is a clinical professor at Macquarie University and The Australian School Of Advanced Medicine, a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group.