Knee Dislocation in Athletes

Knee dislocation is an uncommon but devastating injury to athletes, with significant risks of concurrent vascular and neurologic injury. A well-performed history and physical exam and review of video footage, if available, assist in making the diagnosis in spontaneously reduced knees. In general, a knee with three injured ligaments is a dislocated knee, even if spontaneously reduced. On-the-field management includes gentle closed reduction for dislocated knees and splinting and transfer to the hospital for further workup. Magnetic resonance imaging and CT angiography are recommended for all athletes to assist in preoperative planning and evaluate for vascular injury. Early surgical intervention within 3 weeks of the injury, with repair or reconstruction of all damaged structures, has demonstrated improved outcomes over delayed surgery and nonsurgical treatment; however, the patient and family must be informed that at least 1 year of rehabilitation will be required, with published rates of return to play between 50 and 80%.