What are the Standard Surgical Procedures for a Dislocated Knee?

Knee Dislocation Surgery: Procedures, Recovery and Risks

Knee dislocations are among the most serious orthopaedic injuries, often resulting from high-impact trauma such as road accidents. Proper and timely medical intervention is crucial to avoid long-term complications, including limb-threatening ischemia. 

Read ahead to understand the treatment and surgical procedures of a dislocated knee, along with its complications, recovery phase, and more details. 

How does a knee dislocation happen?

A knee dislocation happens when the bones that structure the knee joint are forced out of their original alignment, either a knee dislocation involving the femur and tibia, or a patellar dislocation in which the kneecap (patella) comes out of its correct groove. True knee dislocations are typically caused by high-energy trauma, such as car accidents or falls from height, while kneecap dislocations are often the result of lower-energy incidents like sports injuries or direct blows.

Causes of Knee Dislocation

Knee dislocation is a condition in which the bones of the knee joint are forced out of alignment, generally caused by high-energy trauma such as falls from heights, traffic accidents, or sports injuries, but it can also result from low-energy incidents. 

High-Energy Causes

1. Motor vehicle accidents : High-speed collisions or impacts can force the knee to hyperextend or rotate forcefully, resulting in dislocation. 
2. Falls from Crucial heights : A hard landing after a fall can result in sufficient force to dislocate the knee. 
3. Crush Injuries : Being struck in a situation where the knee is crushed can also result in dislocation. 

Low-Energy Causes

1. Sports injuries : Sudden turns, twists, or direct impacts at the time of sports such as basketball, football, or skiing can result in dislocation. 
2. Tripping or falling : A minor fall or twist is highly unlikely to cause a true knee dislocation, which requires massive force. However, a patellar dislocation can occur from relatively minor trauma, especially in individuals with pre-existing knee instability or anatomical variations. 
3. Direct blows to the knee : A direct impact can forcibly trigger the kneecap to come out of its right groove.

What is the Immediate Treatment Protocol for a Dislocated Knee?

Several immediate and vital protocols can be taken during a knee dislocation, such as: 

1  Emergency Management

• Reduction: Immediate realignment of the joint, often done manually under sedation.
• Immobilization: After reduction, the knee is stabilized using splints or external braces.
• Vascular Repair (Optional): If blood flow to the leg is compromised, emergency vascular surgery may be necessary.

2  Pain and Swelling Management

• IV Analgesics: These are intravenous (IV) painkillers and are administered to control severe pain with knee dislocation. These act fast for intense pain. Strong drugs such as opioids are used, often depending on the degree of pain. 
• Ice Packs: Ice packs are used to reduce swelling and numbness in the injured knee. It is crucial to wrap ice in a towel or cloth to protect the skin. Ice should ideally be applied for 15-20 minutes at a time, with short breaks in between. 
• Elevation: The injured knee is raised to heart level to reduce swelling by allowing fluids to drain away from the knee. Pillows, cushions, or any suitable object are often used to lift the leg gently. The knee should be kept elevated for the first few hours. 
   

Patients are usually admitted for close observation, especially if neurovascular injuries are suspected.

What are the Standard Medical Procedures After the Initial Treatment?

Once the knee is stabilized, further interventions may be needed, such as:

●  Ligament Reconstruction Surgery
●  Typically performed after initial swelling subsides
●  It can involve ACL, PCL, and collateral ligaments
●  Often staged in two surgeries if the injury is severe
●  Physiotherapy and Rehabilitation
●  It starts with gentle range-of-motion exercises
●  Progresses to weight-bearing and strengthening routines
●  Full rehab may take 6–12 months
●  Vascular or Nerve Repair Follow-up
●  Regular Doppler ultrasound to check for arterial patency
●  Neurological exams to assess nerve regeneration

What are the Complications When Knee Dislocation is Left Untreated?

Yes, untreated or poorly managed dislocations can lead to the following risks:

●  Chronic instability
●  Post-traumatic arthritis
●  Permanent nerve damage
●  Amputation (in cases with missed vascular injury)
●  Deep vein thrombosis (DVT)

That's why it is classified as an orthopaedic emergency in all tertiary centres.

What is Included in the Recovery Process of a Knee Dislocation?

Recovery from a knee dislocation can be broadly divided into 4 phases, which are:

1. Acute Phase (0–6 Weeks)

●  Rest and immobilization
●  Pain management
●  Passive physiotherapy

2. Intermediate Phase (6–12 Weeks)

●  Controlled weight-bearing
●  Muscle activation
●  Range-of-motion exercises

3. Advanced Phase (3–6 Months)

●  Functional training
●  Balance and proprioception
●  Sport-specific drills (if applicable)

4. Return to Activity (6–12 Months)

●  Clearance based on ligament healing, MRI, and functional assessment

When Should You Seek Medical Care for a Suspected Dislocated Knee?

It’s crucial to seek immediate medical help if you experience any of the following:

●  Sudden knee deformity post-injury
●  Intense pain, inability to move the knee
●  Numbness or discoloration in the foot
●  Absence of a pulse in the foot or ankle

Don't attempt to pop the knee back into place—it can worsen nerve damage or cause blood vessel damage.

A dislocated knee is a medical emergency that requires immediate expert attention.  The treatment path is complex and long-term, encompassing imaging, ligament recovery, rehabilitation, and emergency reduction.  Luckily, patients can obtain complete insurance coverage and receive standardized treatment, free from the burden of excessively high costs.

Also Read:

→ What is ACL Surgery

→ What is Hernia Surgery

→ Which Artery is Used for Bypass Surgery

→ What is the Typical Cost of Phimosis Surgery

→ Coronary Artery Bypass Graft (CABG) Surgery