Dislocation of the knee joint
Football! A tense moment, a dangerous situation – a blow …. Pain and dislocation of the knee. Yes, such injuries are common among athletes, but people who are far from sports are faced with knee damage.

Severe pain in the knee after a fall, the inability to bend the leg at the knee joint, and swelling that appears literally before our eyes are all possible signs of a dislocation of the knee joint. Damage can be different, with the involvement of the ligaments, the joint capsule and the patella, the bones that form the joint. Therefore, you should not self-medicate, use ointments or compresses, hoping that everything will pass by itself. The dislocation must be correctly adjusted, and the joint must be fixed in order for the tissues to recover. If this is not done, you can get acquainted with the habitual dislocation of the knee, when the joint “flies out” from the slightest activity.

The knees are part of the lower extremities, powerful enough joints that hold the weight of the body and pelvis. They are quite mobile and strong, it is not so easy to damage them in ordinary life, and dislocation of the knee joint can occur as a result of quite serious impacts.

Usually this:

  • serious accidents with damage to the legs, sharp shocks to the knees;
  • falling to your feet or knees from a height;
  • strong blows to the knee area in front (less often – behind);
  • sharp twisting, jerky, unnatural movements in the joint in professional sports or team games.

Knee dislocations account for about 2-3% of all types of injuries, but often they are not single, combined with trauma to the chest, pelvis or spine, fractures of the tubular bones of the legs or arms.

The risk of dislocations in the knee is increased in untrained people with weak ligaments who are forced to start playing sports, or in people with skeletal malformations (patella deformities, connective tissue dysplasia).

Types of dislocations of the knee joint

In order for the doctor to choose the most correct treatment tactics, all variants of knee dislocations are classified according to certain criteria. This helps to determine whether the patient can be treated conservatively or whether surgery will be necessary.

Possible trauma in the patella (it is somewhat lighter) and damage to the tibia. If the bone is affected, you will have to do an operation on the knee, with such a dislocation, the ligaments are torn, the nerves and large vessels are damaged.

There are also several types of dislocation, depending on the damage to certain ligaments. It is important to emphasize that this is a powerful and strengthened joint, just because the bones do not move, the ligaments and the articular bag, the patella are necessarily injured.

  • anterior dislocation – perhaps one of the most common injuries, with it there is a rupture of powerful cruciate ligaments;
  • posterior – it is diagnosed if the blow fell on the popliteal fossa, the cruciate ligaments also suffer;
  • external – with it, a side impact breaks the anterior cruciate ligament, the lateral ligament (collateral) also partially suffers;
  • internal – with it, due to a blow or a sharp movement of the bone, the rupture occurs in the zone of the medial collateral ligament.

Injury with incomplete dislocation is possible (traumatologists usually call this condition subluxation of the knee) and complete, when the injury is especially serious. The knee lesion can be closed when the ligaments and the joint capsule are injured without breaking the skin, and when open, the joint is in contact with the environment, all tissues in the knee area are damaged.

Due to the occurrence of dislocations in the knee area are divided into:

  • traumatic – its cause is clear from the name;
  • pathological, which is formed against the background of diseases of the joints – arthritis, arthrosis;
  • congenital – the pathology of the knee joint occurs in the womb, the joints are underdeveloped, the bones are connected incorrectly.

A special variant of damage to the knee joint is the so-called habitual dislocation. It is formed with constant injury to the knees, if a person has suffered ligament ruptures or sprains at least 3-4 times. In this case, the joint is “loose” and cannot hold all its parts in place with the slightest awkward movement.

Symptoms of a dislocated knee

In many ways, the symptoms of dislocation of the knee joint depend on at what age and for what reason the injury was received. If only the patella region is affected, the manifestations will not be as bright and painful as when the tibia is involved. Naturally, the very first and vivid manifestation will be acute, severe pain. It is accompanied by the following symptoms:

  • swelling around the knee is rapidly developing;
  • a hematoma appears, bruising under the skin due to rupture of blood vessels;
  • the leg in the joint area does not move, any attempts to move it respond with acute pain;
  • outwardly, the joint looks deformed, the lower leg and foot can be turned to the side.
  • the leg may become numb, somewhat shorter in length from the lower leg to the foot.

In some cases, against the background of stress and pain, active inflammation of the tissues in the area of ​​the affected joint, the temperature may slightly increase.

With subluxation, there is practically no deformation of the joint, the swelling is not very strong, but the pain is sharp and does not allow normal movement of the leg.

If the tibia is damaged, in addition to the written symptoms, more specific manifestations are also possible:

  • complete immobility of the knee, any movement of the leg is almost impossible;
  • the injured leg is clearly shorter than the healthy one;
  • the area of ​​the patella is sharply shifted to the side;
  • the skin becomes cold and pale, its sensitivity is disturbed, there may be complete paralysis below the knee;
  • tubercles are visible on the anterior part of the lower leg.

With a posterior dislocation, if the vessels and nerves suffer, a sharp displacement of the patella is seen, the leg is unnaturally overbent, numb, hematomas form, the edges of the femur are visible in the anterior part in the form of two tubercles.

Treatment of dislocation of the knee joint

If you suspect a dislocation of the knee, it is important to immediately contact the traumatology. The victim should be examined by a traumatologist or orthopedic surgeon to exclude fractures and concomitant injuries. In case of damage to the nerve trunks and blood vessels, a neurosurgeon and a vascular surgeon may be needed.

But before treating an injury, a complete and accurate diagnosis is needed. She will determine the treatment strategy.

Diagnostics

An experienced doctor may suspect damage to the knee joint already at the first examination of the patient. But radiography can confirm and clarify the severity of the injury. Until it is performed, the dislocation is not reduced, they try not to touch the leg so as not to cause unnecessary injury. Every 10th dislocation is accompanied by fractures.

If the x-ray does not give a clear picture, an MRI or CT of the joint, an ultrasound examination, or diagnostic arthroscopy (examination of the joint cavity through a puncture to introduce the device with a camera) is performed. Naturally, arthroscopy is done under local anesthesia and only in extreme cases. When certain problems are detected, it also allows you to immediately carry out therapeutic actions.

Modern treatments

The tactics of therapy is determined by the severity and type of dislocation. If it is incomplete, the dislocation is usually reduced and an immobilization bandage (or orthopedic construction) is applied to fix the calyx in its rightful place.

But a complete dislocation with a torn ligament, a fracture of the bones is an indication for surgery. If it is not carried out, you can remain disabled. The joint will be deformed and immobile.

Reduction and bandaging is a painful procedure, performed only under anesthesia. In children, this is general anesthesia, in adults, local anesthesia. After repositioning the imposition of fixing bandages, control pictures are taken, and only after this the patient goes home for aftercare.

If blood has accumulated inside the joint cavity, it is removed during atroscopy or puncture, so the joint will heal faster, it hurts less. Then a plaster or fixing orthopedic construction will be applied. You need to move before removing the bandage using crutches to relieve the sore joint.

If a ligament rupture is detected, damage to the articular capsule, nerves, blood vessels are affected, the tibia is involved, these are indications for surgery. It is also recommended for chronic dislocations and if conventional treatment does not help.

During the operation, surgeons reduce the dislocation, sew all the vessels and nerves together, and restore the integrity of the ligaments. After suturing, the affected limb is immobilized, the use of medicines, physiotherapy and exercise therapy is indicated.

All this is necessary so that the tissues recover as quickly as possible, the functions of the knee are not lost, blood circulation and muscle tone are restored. The first exercise therapy sessions are conducted only by an experienced doctor, he teaches the patient subsequent independent exercises.

After the operation, painkillers are indicated, and then a course of chondroprotectors – drugs to restore the integrity of the joints, as well as multivitamins with minerals. As the condition improves, electrophoresis, UV therapy are used.

Prevention of dislocation of the knee joint

People at risk need to be aware of special security measures. Thus, prevention of dislocation of the knee joint is especially important for sports professionals – football players, hockey players, runners. Here are some tips to help prevent injury:

  • wearing comfortable shoes with non-slip soles, tight fixation of the leg in the ankle area;
  • wearing knee pads for hazardous activities where the risk of falls is high;
  • strengthening the skeleton and ligaments through regular physical activity;
  • the use of tapes, elastic bandages or orthopedic structures with heavy loads on the knees.

Popular questions and answers

We asked you to answer questions related to dislocation of the knee joint traumatologist-orthopedic doctor Valentyn Panov.

How to provide first aid for a dislocated knee joint?

First aid for dislocation of the knee joint is to create rest for the injured limb. For this, improvised means are used – long, durable objects to which the leg is tied, preventing it from bending and unbending at the knee. The victim must be taken to the hospital as soon as possible, because when the knee joint is dislocated, large vessels and nerves are sometimes damaged.

What are the possible complications of a knee dislocation?

Complete dislocation of the knee joint is often complicated by ruptures of the periarticular and intraarticular ligaments. We need intra-articular ligaments for the proper functioning of the knee, and therefore today we restore them in the operating room. With severe damage to the external lateral ligament, the peroneal nerve is damaged, sensitivity disappears on the lower leg and the muscles stop working. Sometimes at the moment of dislocation, the popliteal vessels and nerves are damaged, this is a dangerous condition that requires prompt medical intervention.

Leave a Reply