A Knee Joint Dislocation or Tibiofemoral Joint Dislocation is an extremely serious injury, imposing a threat to limb presence and its functionality. The dislocation occurs when the bone of the legs, tibia and femur, are out-of-place in relation to each other. The four major ligaments responsible for providing stability for the joint are anterior cruciate, posterior cruciate, lateral collateral, and medial collateral ligaments. A Tibiofemoral Joint Dislocation injures both cruciate ligaments and one or both of the collateral ligaments. Prompt treatment including reduction and assessment of neurovascular damage coupled with extensive rehabilitation program can greatly improve patient’s condition.
A Knee Joint Dislocation may occur due to high-energy trauma, such as,
- Motor Vehicle accidents
- Auto-Pedestrian accidents
- Industrial accidents
- Sports-Related injuries
Signs & Symptoms
The common symptoms of Knee Joint Dislocation are as follows:
- Severe pain in the knee
- Absent/decreased pulse below the knee
- Loss of feeling or movement below the knee
When a Knee Joint Dislocation occurs, one should immediately consult an Orthopedic.
The doctor will carry out the diagnosis in the following way:
History: The doctor will require information about the symptoms, current medication, injuries, and overall health condition of the patient.
Physical Examination: This involves checking the patient’s ability to move the foot up & down and to turn it inside and outside. The specialist will look for numbness which may indicate an injury to the nerves. The examination will also include checking of pulses in the foot for any injury in the artery.
Tests: The doctor will perform X-Rays to ensure that there are no breaks in the bone.
Treatment Modalities Available for Management of the Disorder
Since a Knee Joint Dislocation is an orthopedic emergency, hence one should take immediate steps for its management and treatment. The goals of treatment are to restore functionality and mobility of the knee-joint, by ensuring proper healing of vascular injuries and damage occurred to nerves, ligament, cartilage, and meniscus. The steps for treatment of a Knee Joint Dislocation are as follows:
Reduction: The first and the most essential step is performing a reduction, implying moving the lower leg back into its position. Prior to reduction, the doctor may provide pain medication or partial sedation to the patient. This would enable the patient to withstand the discomfort of relocation.
Immobilization: To prevent further injury and to initiate the healing process of the tissues, the specialist may wrap the knee in a brace, splint, or immobilizer.
Assessment of Neurovascular Injury: Post reduction, it is paramount to assess the neurovascular function of the patient and acutely manage neurovascular injuries, if any.
Surgery: It is usually essential to repair and reconstruct the damaged ligaments with the help of surgery, as a Knee Joint Dislocation may induce several tears and sprains of ligaments or breaks in bones of the knee.
Rehabilitation: After the removal of sling/brace, the doctor may suggest a rehabilitation program for strengthening the knee-joint and restoring its motion.
Improper or delayed treatment of a Knee Joint Dislocation may lead to potential loss of limb. Other known complications include Knee Stiffness, Chronic Instability, and Chronic Pain. Neurovascular injury if left untreated, may lead to above-the-knee amputation.
Patients suffering from a Knee Joint Dislocation should undertake the following precautions:
- Do not put stress on the affected knee.
- Keep the knee elevated as much as possible.
- Avoid strenuous activities.
- Regularly follow-up with the doctor for clinical examination of the knee.
- Strictly follow the rehabilitation program suggested by the specialist for achieving functional recovery.
Dietary & Physical Activity Requirements
The patient should avoid high-energy activities and should keep the knee wrapped in supportive devices to reduce stress on the knee. Depending upon the severity, the doctor may advice the use of crutches. The patient may also have to undertake a physical therapy program aiming at strengthening and achieving full range of motion.
Prevention of the Disorder from Happening or Recurring
One cannot do much to prevent a Knee Joint Dislocation, apart from avoiding falls or trauma. One should take proper care while undertaking impact sports or high-energy activities. While engaging in industrial activities, one should use proper safety equipment.
Support and Help given by the Caregiver
Knee Joint Dislocation is an orthopedic emergency and caregivers should immediately take the patient to a specialist for treatment. After discharge from the hospital, the patient may have to take the support of devices to protect the knee from further injury. Under such circumstances, family members should help the patient in carrying out daily tasks and activities.