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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2021, Number 2

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Acta Ortop Mex 2021; 35 (2)

Vascular injury associated with knee dislocation

Gómez-Bermúdez S, Vanegas-Isaza D, Herrera-Almanza L, Roldán-Tabares M, Coronado-Magalhaes G, Fernández-Lopera J, Martínez-Sánchez L

Language: Spanish
References: 80
Page: 226-235
PDF size: 283.77 Kb.


ABSTRACT

Introduction: Knee dislocation is a rare injury but considered serious clinically since it can be accompanied by vascular and neurological injuries that if they do not have a timely diagnosis and treatment can lead to the loss of the limb. Regarding vascular injury, the optimal diagnostic method for the identification of this type of lesion is of the utmost importance. Objective: To present the literature review on the epidemiology, classification and diagnostic approach of knee dislocation with or without associated vascular injury. Methods: Report of the literature found in databases and analyses based on clinical experience and synthesis of these documents. Conclusion: Vascular injury is not an uncommon finding in the context of knee dislocation, with a high risk of complications and even amputation if an early diagnosis is not made, the authors recommend angio-CT to confirm the suspected diagnosis and not delay treatment.


REFERENCES

  1. Darcy G, Edwards E, Hau R. Epidemiology and outcomes of traumatic knee dislocations: Isolated vs multi-trauma injuries. Injury. 2018; 49(6):1183-7. doi: 10.1016/j.injury.2018.02.016.

  2. Parker S, Handa A, Deakin M, Sideso E. Knee dislocation and vascular injury: 4-year experience at a UK Major Trauma Centre and vascular hub. Injury. 2016; 47(3): 752-6. doi: 10.1016/j.injury.2015.11.014.

  3. McKee L, Ibrahim MS, Lawrence T, Pengas IP, Khan WS. Current concepts in acute knee dislocation: the missed diagnosis? Open Orthop J. 2014; 8: 162-7. doi: 10.2174/1874325001408010162.

  4. Howells NR, Brunton LR, Robinson J, Porteus AJ, Eldridge JD, Murray JR. Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury. 2011; 42(11): 1198-204. doi: 10.1016/j.injury.2010.11.018.

  5. Medina O, Arom GA, Yeranosian MG, Petrigliano FA, McAllister DR. Vascular and nerve injury after knee dislocation: a systematic review. Clin Orthop Relat Res. 2014; 472(9): 2621-9. doi: 10.1007/s11999-014-3511-3.

  6. Bui KL, Ilaslan H, Parker RD, Sundaram M. Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings. Skeletal Radiol. 2008; 37(7): 653-61. doi: 10.1007/s00256-008-0490-z.

  7. Mills WJ, Barei DP, McNair P. The value of the ankle-brachial index for diagnosing arterial injury after knee dislocation: a prospective study. J Trauma. 2004; 56(6): 1261-65.

  8. Nicandri GT, Chamberlain AM, Wahl CJ. Practical management of knee dislocations: a selective angiography protocol to detect limb-threatening vascular injuries. Clin J Sport Med. 2009; 19(2): 125-9. doi: 10.1097/JSM.0b013e31819cd37a.

  9. Hollis JD, Daley BJ. 10-year review of knee dislocations: is arteriography always necessary? J Trauma. 2005; 59(3): 672-5.

  10. Alvarez LA, Garcia LY, Casanova MC, Muñoz IA. Luxación traumática de la rodilla, diagnóstico y tratamiento. Rev Cubana Ortop Traumatol. 2007; 21(2): 1-11.

  11. Novoa Sierra B, Estrems Diaz V, Garcia Peñuela JS, Bru Pomer A. Luxaciones de rodilla: revisión de 11 casos. Revista Española de Cirugía Osteoarticular. 2015; 50(262): 123-7.

  12. Shelbourne KD, Gray T. Anterior cruciate ligament injury combined with medial collateral ligament, posterior cruciate ligament, and/or lateral collateral ligament injury. The Anterior Cruciate Ligament. 2018; 2: 393-8.

  13. Vaidya R, Roth M, Nanavati D, Prince M, Sethi A. Low-velocity knee dislocations in obese and morbidly obese patients. Orthop J Sports Med. 2015; 3(4): 2325967115575719. doi: 10.1177/2325967115575719.

  14. Carral RLE, Frías GH, Diego BD. Luxación de rodilla. Presentación de un caso clínico y revisión de la literatura. An Med Asoc Med Hosp ABC. 1999; 44(2): 86-90.

  15. Liow RY, McNicholas MJ, Keating JF, Nutton RW. Ligament repair and reconstruction in traumatic dislocation of the knee. J Bone Joint Surg Br. 2003; 85(6): 845-51.

  16. Berkson EM, Nolan D, Fleming K, Spang R, Wong J, Asnis P, et al. Knee: ligamentous and patellar tendon injuries. Pathol Interv Musculoskelet Rehabil. 2016; 2: 713-73.

  17. McDonough EB Jr, Wojtys EM. Multiligamentous injuries of the knee and associated vascular injuries. Am J Sports Med. 2009; 37(1): 156-9. doi: 10.1177/0363546508324313.

  18. Skendzel JG, Sekiya JK, Wojtys EM. Diagnosis and management of the multiligament-injured knee. J Orthop Sports Phys Ther. 2012; 42(3): 234-42. doi: 10.2519/jospt.2012.3678.

  19. Piper D, Howells NR. Acute knee dislocation. Trauma. 2014; 16(2): 70-8.

  20. Watson J, Schreiber V, Harner, Musahl V. The dislocated knee. In: Atchabahian A, Baer GS, Bedi A, et al. Insall & scott surgery of the knee. Sixth ed. Spain; Elsevier 2018; 63: 819-32.e2.

  21. Fitzgerald J, Richter D, Waschery D, Schenck R. Classification of knee dislocations. In: Sue D. Barber-Westin, BS, Director, clinical and applied research. Noyes' knee disorders: surgery, rehabilitation. Clinical outcomes. 2nd ed. Cincinnati, Ohio, Elsevier; 2017.21, 654-62.

  22. Mascioli AA. Acute dislocations. In: Daugherty K. Linda Jones editor. Campbell's operative orthopaedics. 13th ed. Philadelphia. Elsevier. 2017 Chapter 60, 3117-136.e4.

  23. Chowdhry M, Burchette D, Whelan D, Nathens A, Marks P, Wasserstein D. Knee dislocation and associated injuries: an analysis of the American College of Surgeons National Trauma Data Bank. Knee Surg Sports Traumatol Arthrosc. 2019 doi: 10.1007/s00167-019-05712-y.

  24. Boisrenoult P, Lustig S, Bonneviale P, Leray E, Versier G, Neyret P, et al. Vascular lesions associated with bicruciate and knee dislocation ligamentous injury. Orthop Traumatol Surg Res. 2009; 95(8): 621-6. doi: 10.1016/j.otsr.2009.10.002.

  25. Moatshe G, Dornan GJ, Løken S, Ludvigsen TC, LaPrade RF, Engebretsen L. Demographics and injuries associated with knee dislocation: a prospective review of 303 patients. Orthop J Sports Med. 2017; 5(5): 2325967117706521. doi: 10.1177/2325967117706521.

  26. Lustig S, Leray E, Boisrenoult P, Trojani C, Laffargue P, Saragaglia D, et al. Dislocation and bicruciate lesions of the knee: epidemiology and acute stage assessment in a prospective series. Orthop Traumatol Surg Res. 2009; 95(8): 614-20. doi: 10.1016/j.otsr.2009.10.005.

  27. Cvetkovic S, Jakovljevic N, Simic D, Sladojevic M, Djurasic L, Davidovic L. Popliteal artery injury following traumatic knee joint dislocation in a 14-year-old boy: a case report and review of the literature. Vojnosanit Pregl. 2014; 71(1): 87-90.

  28. López-Hualda A, Valencia-García H, Martínez-Martín J. Vascular injuries associated with dislocation of the knee: diagnosis protocol. Rev Esp Cir Ortop Traumatol. 2012; 56(4): 260-6. doi: 10.1016/j.recot.2011.12.005.

  29. Miranda FE, Dennis JW, Veldenz HC, Dovgan PS, Frykberg ER. Confirmation of the safety and accuracy of physical examination in the evaluation of the knee dislocation for injury of the popliteal artery: a prospective study. J Trauma. 2002; 52(2): 247-52.

  30. Stannard JP, Sheils TM, López-Ben RR, McGwin G, Robinson JT, Volgas DA. Vascular injuries in knee dislocations: the role of physical examination in determining the need for arteriography. J Bone Joint Surg Am. 2004; 86(5): 910-5.

  31. Georgiadis AG, Mohammad FH, Mizerik KT, Nypaver TJ, Shepard AD. Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese. J Vasc Surg. 2013; 57(5): 1196-203. doi: 10.1016/j.jvs.2012.11.067.

  32. Barnes CJ, Pietrobon R, Higgins LD. Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta-analysis. J Trauma. 2002; 53: 1109-14.

  33. Witz M, Witz S, Tobi E, Shnaker A, Lehmann J. Isolated complete popliteal artery rupture associated with knee dislocation. Case reports. Knee Surg Sports Traumatol Arthrosc. 2004; 12: 3-6.

  34. Johansen K, Lynch K, Paun M, Copass M. Non-invasive vascular tests reliably exclude occult arterial trauma in injured extremities. J Trauma. 1991; 31(4): 515-9.

  35. Seroyer ST, Musahl V, Harner CD. Management of the acute knee dislocation: the Pittsburgh experience. Injury. 2008; 39(7): 710-8. doi: 10.1016/j.injury.2007.11.022.

  36. Urgüden M, Bilbasar H, Ozenci AM, Akyildiz FF, Gür S. Irreducible posterolateral knee dislocation resulting from a low-energy trauma. Arthroscopy. 2004; 20 Suppl 2: 50-3.

  37. Harb A, Lincoln D, Michaelson J. The MR dimple sign in irreducible posterolateral knee dislocations. Skeletal Radiol. 2009; 38(11): 1111-4. doi: 10.1007/s00256-009-0729-3.

  38. Boyce RH, Singh K, Obremskey WT. Acute management of traumatic knee dislocations for the generalist. J Am Acad Orthop Surg. 2015; 23(12): 761-8. doi: 10.5435/JAAOS-D-14-00349.

  39. Pardiwala DN, Rao NN, Anand K, Raut A. Knee dislocations in sports injuries. Indian J Orthop. 2017; 51: 552-62.

  40. Treiman GS, Yellin AE, Weaver FA, Wang S, Ghalambor N, Barlow W, et al. Pentecost MJ. Examination of the patient with a knee dislocation. The case for selective arteriography. Arch Surg. 1992; 127(9): 1056-62.

  41. Harner CD, Harner CD. The multiple ligament injured knee. Clin Sports Med. 1999; 18(1): 241-62.

  42. Juhng SK, Lee JK, Choi SS, Yoon KH, Roh BS, Won JJ. MR Evaluation of the "arcuate" sign of posterolateral knee instability. AJR Am J Roentgenol. 2002; 178(3): 583-8.

  43. Crimmins JT, Wissman RD. The Arcuate sign: a marker of potential knee dislocation? A report of two cases. Radiol Case Rep. 2015; 3(2): 160. doi: 10.2484/rcr.v3i2.160.

  44. Gray JL, Cindric M. Management of arterial and venous injuries in the dislocated knee. Sports Med Arthrosc Rev. 2011; 19(2): 131-8. doi: 10.1097/JSA.0b013e3182191a9c.

  45. Fry WR, Smith RS, Sayers DV, Henderson VJ, Morabito DJ, Tsoi EK, et al. The success of duplex ultrasonographic scanning in diagnosis of extremity vascular proximity trauma. Arch Surg. 1993; 128(12): 1368-72. doi: 10.1001/archsurg.1993.01420240076015.

  46. Knudson MM, Lewis FR, Atkinson K, Neuhaus A. The role of duplex ultrasound arterial imaging in patients with penetrating extremity trauma. Arch Surg. 1993; 128(9): 1033-7; discussion 1037-8. doi: 10.1001/archsurg.1993.01420210097013.

  47. Wascher DC, Dvirnak PC, DeCoster TA. Knee dislocation: initial assessment and implications for treatment. J Orthop Trauma. 1997; 11(7): 525-9. doi: 10.1097/00005131-199710000-00011.

  48. Khakha RS, Day AC, Gibbs J, Allen S, Hill P, Hull J, et al. Acute surgical management of traumatic knee dislocations. Average follow-up of 10 years. Knee. 2016; 23(2): 267-75. doi: 10.1016/j.knee.2015.09.019.

  49. Kennedy JC. Complete dislocation of the knee joint. J Bone Joint Surg Am. 1963; 45: 889-904.

  50. Green NE, Allen BL. Vascular injuries associated with dislocation of the knee. J Bone Joint Surg Am. 1977; 59(2): 236-9.

  51. Gable DR, Allen JW, Richardson JD. Blunt popliteal artery injury: is physical examination alone enough for evaluation? J Trauma. 1997; 43(3): 541-4.

  52. McCutchan JD, Gillham NR. Injury to the popliteal artery associated with dislocation of the knee: palpable distal pulses do not negate the requirement for arteriography. Injury. 1989; 20(5): 307-10. doi: 10.1016/0020-1383(89)90180-0.

  53. Bryan T, Merritt P, Hack B. Popliteal arterial injuries associated with fractures or dislocations about the knee as a result of blunt trauma. Orthop Rev. 1991; 20(6): 525-30.

  54. Melton SM, Croce MA, Patton JH Jr, Pritchard FE, Minard G, Kudsk KA, Fabian TC. Popliteal artery trauma. Systemic anticoagulation and intraoperative thrombolysis improves limb salvage. Ann Surg. 1997; 225(5): 518-27; discussion 527-9. doi: 10.1097/00000658-199705000-00009.

  55. Rihn JA, Groff YJ, Harner CD, Cha PS. The acutely dislocated knee: evaluation and management. J Am Acad Orthop Surg. 2004; 12(5): 334-46.

  56. Rose SC, Moore EE. Trauma angiography: the use of clinical findings to improve patient selection and case preparation. J Trauma. 1988; 28(2): 240-5.

  57. Welling RE, Kakkasseril J, Cranley JJ. Complete dislocations of the knee with popliteal vascular injury. J Trauma. 1981; 21(6): 450-3.

  58. Lefrak EA. Knee dislocation. An illusive cause of critical arterial occlusion. Arch Surg. 1976; 111(9): 1021-4. doi: 10.1001/archsurg.1976.01360270093018.

  59. Collins HA, Jacobs JK. Acute arterial injuries due to blunt trauma. J Bone Joint Surg Am. 1961; 43-A: 193-7.

  60. Jones RE, Smith EC, Bone GE. Vascular and orthopedic complications of knee dislocation. Surg Gynecol Obstet. 1979; 149(4): 554-8.

  61. Alberty RE, Goodfried G, Boyden AM. Popliteal artery injury with fractural dislocation of the knee. Am J Surg. 1981; 142(1): 36-40.

  62. Wascher DC. High-velocity knee dislocation with vascular injury. Treatment principles. Clin Sports Med. 2000; 19(3): 457-77.

  63. Klineberg EO, Crites BM, Flinn WR, Archibald JD, Moorman CT 3rd. The role of arteriography in assessing popliteal artery injury in knee dislocations. J Trauma. 2004; 56(4): 786-90. doi: 10.1097/01.ta.0000075346.05460.d6.

  64. Applebaum R, Yellin AE, Weaver FA, Oberg J, Pentecost M. Role of routine arteriography in blunt lower-extremity trauma. Am J Surg. 1990; 160(2): 221-5.

  65. Abou-Sayed H, Berger DL. Blunt lower-extremity trauma and popliteal artery injuries: revisiting the case for selective arteriography. Arch Surg. 2002; 137(5): 585-9. doi: 10.1001/archsurg.137.5.585.

  66. Stain SC, Yellin AE, Weaver FA, Pentecost MJ. Selective management of nonocclusive arterial injuries. Arch Surg. 1989; 124(10): 1136-40; discussion 1140-1.

  67. Kaufman SL, Martin LG. Arterial injuries associated with complete dislocation of the knee. Radiology. 1992; 184(1): 153-5. doi: 10.1148/radiology.184.1.1609074.

  68. Dennis JW, Jagger C, Butcher JL, Menawat SS, Neel M, Frykberg ER. Reassessing the role of arteriograms in the management of posterior knee dislocations. J Trauma. 1993; 35(5): 692-5; discussion 695-7. doi: 10.1097/00005373-199311000-00007.

  69. Walker RE, McDougall D, Patel S, Grant JA, Longino PD, Mohtadi NG. Radiologic review of knee dislocation: from diagnosis to repair. AJR Am J Roentgenol. 2013; 201(3): 483-95. doi: 10.2214/AJR.12.10221.

  70. Vinyard TR, Boyd J, MacDonald PB. Initial evaluation of the acute and chronic multiple ligament injured knee. J Knee Surg. 2012; 25(4): 275-86. doi: 10.1055/s-0032-1322598.

  71. Gakhal MS, Sartip KA. CT angiography signs of lower extremity vascular trauma. AJR Am J Roentgenol. 2009; 193(1): 49-57. doi: 10.2214/AJR.08.2011.

  72. Inaba K, Potzman J, Munera F, McKenney M, Munoz R, Rivas L, et al. Multi-slice CT angiography for arterial evaluation in the injured lower extremity. J Trauma. 2006; 60(3): 502-6.

  73. Rieger M, Mallouhi A, Tauscher T, Lutz M, Jaschke WR. Traumatic arterial injuries of the extremities: initial evaluation with MDCT angiography. AJR Am J Roentgenol. 2006; 186(3): 656-64. doi: 10.2214/AJR.04.0756.

  74. Tocci SL, Heard WM, Fadale PD, Brody JM, Born C. Magnetic resonance angiography for the evaluation of vascular injury in knee dislocations. J Knee Surg. 2010; 23(4): 201-7.

  75. Baum RA, Rutter CM, Sunshine JH, Blebea JS, Blebea J, Carpenter JP, et al. Multicenter trial to evaluate vascular magnetic resonance angiography of the lower extremity. American College of Radiology Rapid Technology Assessment Group. JAMA. 1995; 274(11): 875-80.

  76. Lachman JR, Rehman S, Pipitone PS. Traumatic knee dislocations: evaluation, management, and surgical treatment. Orthop Clin North Am. 2015; 46(4): 479-93. doi: 10.1016/j.ocl.2015.06.004.

  77. Potter HG, Weinstein M, Allen AA, Wickiewicz TL, Helfet DL. Magnetic resonance imaging of the multiple-ligament injured knee. J Orthop Trauma. 2002; 16(5): 330-9. doi: 10.1097/00005131-200205000-00007.

  78. Köhler C, Weishaupt D, Guggenheim M, Künzi W, Wedler V. Magnet resonance angiography versus conventional angiography for the planning of reconstructive surgeries. Eur J Trauma Emerg Surg. 2007; 33(1): 40-5. doi: 10.1007/s00068-007-5130-0.

  79. Bonnevialle P, Pidhorz L; Membres du Groupe d'Etude en Traumatologie Ostéoarticulaire (GETRAUM). Dislocation and fractures around the knee with popliteal artery injury: A retrospective analysis of 54 cases]. Rev Chir Orthop Reparatrice Appar Mot. 2006; 92(5): 508-16. doi: 10.1016/s0035-1040(06)75840-8.

  80. Teissier V, Tresson P, Gaudric J, Davaine JM, Scemama C, Raux M, et al. Importance of early diagnosis and care in knee dislocations associated with vascular injuries. Ann Vasc Surg. 2019; pii: S0890-5096(19)30469-8. doi: 10.1016/j.avsg.2019.04.016.




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