Knee dislocation: initial assessment and implications for treatment.

OBJECTIVE

To evaluate bicruciate knee injuries and determine whether they should be treated as knee dislocations, especially with regard to vascular injuries.

DESIGN

Retrospective.

SETTING

University hospital, level 1 trauma center.

PATIENTS

Fifty patients admitted between 1987 and 1994 who had sustained knee dislocations or bicruciate ligament injuries.

MAIN OUTCOME MEASURES

Mechanism of injury, direction of dislocation, knee ligament injury pattern, presence or absence of periarticular fracture, presence of vascular and nerve injuries, and location of associated trauma were measured.

RESULTS

Twenty-two knees had classic knee dislocations. Twenty-eight knees presented as "reduced" bicruciate ligament injuries. Vascular injury occurred just as frequently in bicruciate ligament injuries as in knee dislocations. The direction of the knee dislocation did not predict ligament injury pattern or the presence of arterial injury.

CONCLUSION

Bicruciate ligament injuries are equivalent to knee dislocations with regard to mechanism of injury, severity of ligamentous injury, and frequency of major arterial injuries.