[The acute knee injury - practical considerations].

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Abstract

[Indexed for MEDLINE] 20. Eur J Orthop Surg Traumatol. 2018 Aug;28(6):1001-1015. doi: 10.1007/s00590-018-2148-4. Epub 2018 Feb 22. Management of knee dislocation prior to ligament reconstruction: What is the current evidence? Update of a universal treatment algorithm. Maslaris A(1), Brinkmann O(2), Bungartz M(2), Krettek C(3), Jagodzinski M(3), Liodakis E(3). Author information: (1)Department of Orthopaedics, Rudolf-Elle-Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klostersnitzer Straße 81, 07607, Eisenberg, Germany. a.maslaris@krankenhaus-eisenberg.de. (2)Department of Orthopaedics, Rudolf-Elle-Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klostersnitzer Straße 81, 07607, Eisenberg, Germany. (3)Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Traumatic knee dislocation is a rare but potentially limb-threatening injury. Thus proper initial diagnosis and treatment up to final ligament reconstruction are extremely important and a precondition to successful outcomes. Reports suggest that evidence-based systematic approaches lead to better results. Because of the complexity of this injury and the inhomogeneity of related literature, there are still various controversies and knowledge gaps regarding decision-making and step-sequencing in the treatment of acute multi-ligament knee injuries and knee dislocations. The use of ankle-brachial index, routine or selective angiography, braces, joint-spanning or dynamic external fixation, and the necessity of initial ligament re-fixation during acute surgery constitutes current topics of a scholarly debate. The aim of this article was to provide a comprehensive literature review bringing light into some important aspects about the initial treatment of knee dislocation (vascular injury, neural injury, immobilization techniques) and finally develop an accurate data-based universal algorithm, enabling attending physicians to become more acquainted with the management of acute knee dislocation. DOI: 10.1007/s00590-018-2148-4