Vascular and orthopedic complications of knee dislocation.

Experience with complete dislocation of the knee in 22 consecutive patients during a six year period was analyzed. Major vascular complications occurred in nine of 13 extremities with anterior dislocation, one of seven extremities with posterior dislocation and none of two extremities with lateral dislocation. Liberal use of trans-femoral ateriography for diagnosis disclosed significant arterial injuries in four of 15 limbs, despite postreduction pedal pulses which were apparently normal. Limb salvage was accomplished in 20 of 21 survivors and in eight of nine with associated vascular complications. All patients demonstrated severe instability of the ligamentous structures of the knee consistent with the type of dislocation. Posterior instability was severe in all patients, an indication of disruption of the posterior cruciate ligament in every instance. Adequate follow-up information was available on 12 knees that had primary ligamentous repair, ten of which were stable to stress testing. Postoperative immobilization was accomplished by external skeletal fixation, skeletal traction or long leg posterior plaster splint.