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Tibiofemoral Dislocation
Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Knee dislocation, multiligament injured knee
          • Definitions

            • Traumatic disruption/displacement of tibiofemoral joint

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Dosher WB et al: Multiple ligament knee injuries: current state and proposed classification. Clin Sports Med. 38(2):183-92, 2019
                                        2. Fanelli GC: Multiple ligament injured knee: initial assessment and treatment. Clin Sports Med. 38(2):193-8, 2019
                                        3. Richter DL et al: Knee dislocation (KD) IV injuries of the knee: presentation, treatment, and outcomes. Clin Sports Med. 38(2):247-60, 2019
                                        4. Krych AJ et al: Meniscal tears and articular cartilage damage in the dislocated knee. Knee Surg Sports Traumatol Arthrosc. 23(10):3019-25, 2015
                                        5. Sheehan SE et al: A biomechanical approach to interpreting magnetic resonance imaging of knee injuries. Magn Reson Imaging Clin N Am. 22(4):621-48, 2014
                                        6. Werner BC et al: Ultra-low velocity knee dislocations: patient characteristics, complications, and outcomes. Am J Sports Med. 42(2):358-63, 2014
                                        7. Walker RE et al: Radiologic review of knee dislocation: from diagnosis to repair. AJR Am J Roentgenol. 201(3):483-95, 2013
                                        8. Azar FM et al: Ultra-low-velocity knee dislocations. Am J Sports Med. 39(10):2170-4, 2011
                                        9. Howells NR et al: Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury. 42(11):1198-204, 2011
                                        10. Rajeswaran G et al: Radiology and management of multiligament injuries of the knee. Semin Musculoskelet Radiol. 15(1):42-58, 2011
                                        11. Harb A et al: The MR dimple sign in irreducible posterolateral knee dislocations. Skeletal Radiol. 38(11):1111-4, 2009
                                        12. Levy BA et al: Controversies in the treatment of knee dislocations and multiligament reconstruction. J Am Acad Orthop Surg. 17(4):197-206, 2009
                                        13. Levy BA et al: Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy. 25(4):430-8, 2009
                                        14. Nicandri GT et al: Practical management of knee dislocations: a selective angiography protocol to detect limb-threatening vascular injuries. Clin J Sport Med. 19(2):125-9, 2009
                                        15. Robertson A et al: Dislocation of the knee. J Bone Joint Surg Br. 88(6):706-11, 2006
                                        16. Helgeson MD et al: Initial evaluation of the acute and chronic multiple ligament injured knee. J Knee Surg. 18(3):213-9, 2005
                                        17. Giannoulias CS et al: Knee dislocations: management of the multiligament-injured knee. Am J Orthop. 33(11):553-9, 2004
                                        18. Klineberg EO et al: The role of arteriography in assessing popliteal artery injury in knee dislocations. J Trauma. 56(4):786-90, 2004
                                        19. Stannard JP et al: Vascular injuries in knee dislocations: the role of physical examination in determining the need for arteriography. J Bone Joint Surg Am. 86-A(5):910-5, 2004
                                        20. Barnes CJ et al: Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta-analysis. J Trauma. 53(6):1109-14, 2002
                                        21. Perron AD et al: Orthopedic pitfalls in the ED: vascular injury associated with knee dislocation. Am J Emerg Med. 19(7):583-8, 2001
                                        22. Brautigan B et al: The epidemiology of knee dislocations. Clin Sports Med. 19(3):387-97, 2000
                                        23. Hayes CW et al: Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiographics. 20 Spec No:S121-34, 2000
                                        24. Hegyes MS et al: Knee dislocation. Complications of nonoperative and operative management. Clin Sports Med. 19(3):519-43, 2000
                                        25. Twaddle BC et al: MRI in acute knee dislocation. A prospective study of clinical, MRI, and surgical findings. J Bone Joint Surg Br. 78(4):573-9, 1996
                                        26. Yu JS et al: Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging. AJR Am J Roentgenol. 164(1):135-9, 1995
                                        27. Kremchek TE et al: Traumatic dislocation of the knee. Orthop Rev. 18(10):1051-7, 1989
                                        28. Walls RM et al: Traumatic dislocation of the knee. J Emerg Med. 1(6):527-31, 1984
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Pathology

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Knee dislocation, multiligament injured knee
                                                • Definitions

                                                  • Traumatic disruption/displacement of tibiofemoral joint

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Dosher WB et al: Multiple ligament knee injuries: current state and proposed classification. Clin Sports Med. 38(2):183-92, 2019
                                                                              2. Fanelli GC: Multiple ligament injured knee: initial assessment and treatment. Clin Sports Med. 38(2):193-8, 2019
                                                                              3. Richter DL et al: Knee dislocation (KD) IV injuries of the knee: presentation, treatment, and outcomes. Clin Sports Med. 38(2):247-60, 2019
                                                                              4. Krych AJ et al: Meniscal tears and articular cartilage damage in the dislocated knee. Knee Surg Sports Traumatol Arthrosc. 23(10):3019-25, 2015
                                                                              5. Sheehan SE et al: A biomechanical approach to interpreting magnetic resonance imaging of knee injuries. Magn Reson Imaging Clin N Am. 22(4):621-48, 2014
                                                                              6. Werner BC et al: Ultra-low velocity knee dislocations: patient characteristics, complications, and outcomes. Am J Sports Med. 42(2):358-63, 2014
                                                                              7. Walker RE et al: Radiologic review of knee dislocation: from diagnosis to repair. AJR Am J Roentgenol. 201(3):483-95, 2013
                                                                              8. Azar FM et al: Ultra-low-velocity knee dislocations. Am J Sports Med. 39(10):2170-4, 2011
                                                                              9. Howells NR et al: Acute knee dislocation: an evidence based approach to the management of the multiligament injured knee. Injury. 42(11):1198-204, 2011
                                                                              10. Rajeswaran G et al: Radiology and management of multiligament injuries of the knee. Semin Musculoskelet Radiol. 15(1):42-58, 2011
                                                                              11. Harb A et al: The MR dimple sign in irreducible posterolateral knee dislocations. Skeletal Radiol. 38(11):1111-4, 2009
                                                                              12. Levy BA et al: Controversies in the treatment of knee dislocations and multiligament reconstruction. J Am Acad Orthop Surg. 17(4):197-206, 2009
                                                                              13. Levy BA et al: Decision making in the multiligament-injured knee: an evidence-based systematic review. Arthroscopy. 25(4):430-8, 2009
                                                                              14. Nicandri GT et al: Practical management of knee dislocations: a selective angiography protocol to detect limb-threatening vascular injuries. Clin J Sport Med. 19(2):125-9, 2009
                                                                              15. Robertson A et al: Dislocation of the knee. J Bone Joint Surg Br. 88(6):706-11, 2006
                                                                              16. Helgeson MD et al: Initial evaluation of the acute and chronic multiple ligament injured knee. J Knee Surg. 18(3):213-9, 2005
                                                                              17. Giannoulias CS et al: Knee dislocations: management of the multiligament-injured knee. Am J Orthop. 33(11):553-9, 2004
                                                                              18. Klineberg EO et al: The role of arteriography in assessing popliteal artery injury in knee dislocations. J Trauma. 56(4):786-90, 2004
                                                                              19. Stannard JP et al: Vascular injuries in knee dislocations: the role of physical examination in determining the need for arteriography. J Bone Joint Surg Am. 86-A(5):910-5, 2004
                                                                              20. Barnes CJ et al: Does the pulse examination in patients with traumatic knee dislocation predict a surgical arterial injury? A meta-analysis. J Trauma. 53(6):1109-14, 2002
                                                                              21. Perron AD et al: Orthopedic pitfalls in the ED: vascular injury associated with knee dislocation. Am J Emerg Med. 19(7):583-8, 2001
                                                                              22. Brautigan B et al: The epidemiology of knee dislocations. Clin Sports Med. 19(3):387-97, 2000
                                                                              23. Hayes CW et al: Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiographics. 20 Spec No:S121-34, 2000
                                                                              24. Hegyes MS et al: Knee dislocation. Complications of nonoperative and operative management. Clin Sports Med. 19(3):519-43, 2000
                                                                              25. Twaddle BC et al: MRI in acute knee dislocation. A prospective study of clinical, MRI, and surgical findings. J Bone Joint Surg Br. 78(4):573-9, 1996
                                                                              26. Yu JS et al: Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging. AJR Am J Roentgenol. 164(1):135-9, 1995
                                                                              27. Kremchek TE et al: Traumatic dislocation of the knee. Orthop Rev. 18(10):1051-7, 1989
                                                                              28. Walls RM et al: Traumatic dislocation of the knee. J Emerg Med. 1(6):527-31, 1984