Knee Dislocations - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 20 июн 2011
- Educational video describing the types and treatment available for knee dislocations and possible vascular or nerve injuries.
The knee joint allows for flexion and extension. These functions allow the body to perform activities like walking, running and sitting.
Knee dislocations occur as a result of violent trauma. The femur and tibia are not articulating with each other.
The bones of the knee are held together by strong ligaments. For a knee dislocation to occur, 3 out of 4 of these ligaments have to become ruptured.
Types of knee joint dislocations:
•Anterior
•Posterior
•Medial-lateral
•Rotary: usually posterolateral. The medial femoral condyle can button-hole through the medial soft tissues resulting in a “dimple sign”. It is often irreducible.
Posterior dislocation/ dashboard injury
Most common mechanism of injury includes exaggerated hyperextension of the knee and dashboard injuries. Posteriorly directed force with the knee flexed in 90 degrees.
The peroneal nerve is tethered at the fibular neck. The incidence of nerve injury ranges from 14% to 35%.
Arterial injury
•Vascular damage is most common in anterior and posterior dislocations in approximately 40% of the cases. Arterial damage in approximately 20-40% of all knee dislocations. Knee dislocation is associated with a high incidence of popliteal artery injury.
•With an established popliteal artery and resultant ischemia, blood flow must be restored within 6 hours.
•Posterior tibial and dorsalis pedis pulses should be carefully evaluated and compared to the other side in any patient with a knee dislocation.
•Look for any evidence of ischemia, diminished blood flow, or compartment syndrome.
•Urgent reduction of the knee dislocation is mandatory
•Be aware of spontaneously reduced knee dislocations and its associated pathology.
•Reevaluate circulation after reduction, if pulses are normal, serial follow-up up to 48 hours with clinical examination and non-invasive studies (ABI). If ABI is 0.9 or more, then the patient will not have an arterial injury. If pulses are abnormal or different, do arteriography. If no pulses then do an immediate exploration in the OR.
Treatment
•Arterial injury is treated with excision of the damaged segment and reanastmosis with a reverse saphenous vein graft and prophylactic fasciotomy.
•Early surgery if ligament avulsion is present- important ligament to reconstruct is the PCL- if posterolateral corner disruption.
•After reduction, the patient is placed into a knee immobilizer or external fixator.
•Delayed elective reconstruction of the knee ligaments is usually done at a later date.
•The PCL is an important ligament to reconstruct.
Thank you, spread the word!
Vast majority of the commenters below are talking about knee-cap dislocations (patella dislocation). These are not dangerous and do not cause vascular injury. The video is about actual dislocations of the femur vs the tibia. Completely different story
I dislocated my right knee today, the pain...oh the pain is awful, horrible, tenacious, indescribable and then out of nowhere it popped back into place and it hurt a little afterward but truly is one of the worst ligament pains I know.
Same thing happen today when I was playing basketball. When my knee dislocated I was on the ground and my friends were creeped out and were asking to call 911. I was scared asf but it popped right back in and I'm like "ok"
100%.. I absolutely hate that pain.
nick mcduffie I just now popped it and I'm scared. it feel fine now.... i hope it's fine 😢😢
nick mcduffie same dude. I just got home from the hospital from that
why why OMG the exact story happened to me,honestly the pain is beyond explainable and bearable,when I was legit crying my eyes out in hospital cos of the immense pain it went back to its place..
I dislocated my knee last week and now I can finally walk-ish with a splint on it. The pain was the worst thing I've ever experienced
Wonderfully explained, thank you.
Very helpful video. Clear and concise! Thanks.
just for anyone who might be confused a knee dislocation and kneecap dislocation are different injuries
☝️this one.
Well stated friend. Very well
Oow omg I’ve dislocated my knee so many times I honestly have no idea why it happens so much but at least for me it hurts the most when your leg is stretched out and hurts less when you hug your leg to your chest, but the way to pop it back into place is to FULLY straighten out your leg, yess it fucking huts but after you pop it back in the pain slowly goes away
I have this same problem. It dislocates often. Done it 4 times today and it hurts so badly that I get a rush of nausea come over me until I pop it back in by straightening it out. It hurts along the outside of my knee and I don't know how to make it stop. Also, can't find any info about it. I seriously need help...I don't know how much more I can take.
@@stacyqhigginbotham6191 Did u visit a doctor?
I dislocated my knee many times on my right knee that I don't even feel pain anymore. But recently I dislocated my left knee, it went back in place but I couldn't walk properly and THE PAIN OMG.
@nabilebraheim Thanks for your information i did my left knee 2 times its been out of place will a op make any different to the knee?
great job
thank you so much
Thank you....
Thanks!
I've been for nerve conduction studies and been told the nerve appears intact as in its not severed anywhere which is good but that i've stretched the nerve as bad as possible pretty much. A good 7 months before anything started happening with dorsiflexion, and even now 15 months on from injury its still very weak so your definately in the early stages. I was getting sharp stinging sensations down my leg is the best way i can describe it for a couple months before movement
Hay top job mate
Hey I did the same thing to my knee as you and as you are aware it sucks. It seems like you are regaining your nerve function which is awesome. I am not a doctor or anything but I think you have a good chance of recovering and returning to sports. Look up Blaine Irby, he did the same thing and returned to playing college football.
@AGreenWhiteRedA thanks
Medial, is when tibiae goes to medial side but in your video ?
My kneecap had popped out of its socket approx 4 years ago, for what seemed like no reason. Yesterday, in my sleep, my knee popped back out and when I tried to move out of bed it popped back in. You emphasis that injury has to occur, is this always the case?
Do you know the extent of your nerve injury? How long after till you started to gain dorsiflexion? I am 4 months after the injury and no dorsiflexion yet..but i do feel a sensation when I try to dorsiflex, and have nerve pain which i have been told is not a bad sign
I think i lateral dislocation(it went back into place seconds after), any advice? Should i go to the doctor?
What about the Epiphyis&the pics form
Once a knee comes out of joint will it continue to occur like still come out of joint?
محتاجك ي دكتور ف استشاره طبيه سريعه بعد اذنك .. ارجو التواصل معى
I had an mpfl replacement surgery for my left knee almost 9 years ago and I'm getting mpfl replacement surgery for my right knee
I have dislocated my right knee four times… Today was the fourth time . In all cases it has popped out of joint then popped back into place , It’s probably the most painful thing I’ve ever felt in my life .
The fact that you have sensation when trying to dorsiflex is a good sign tho. I looked up Blaine and his story is very encouraging i watched his injury and instantly wished I didnt. Horrific stuff. Are you using a walking aid?
@thomas67129 possible
I dislocated my knee joint about 2 months ago
I was snowboarding yesterday and I fell and heard a pop and my knee hurts so bad I can’t sleep and idk if I dislocated it or what
bro the vein or the artery in the back of my knee moves around eventhough i dislocated my left knee 2 weeks ago
broken patella can band 100% after surgery ????
Dear Dr. Nabil Ebraheim, I have some knee problem and it is increasingly severe as time goes by for which I hope I could get help from you sir. I have O type left leg and X type right leg. As far as I could know that it is a ligament or tendon problem, but so far no doctors in China, including Western medicine and tradiitonal Chinese medicine, can solve this problem, they just shake their heads and say “I cannot help it”.
Would you have any suggestion to me?
Thank you.
Very good informative vid. I dislocated my knee on the 27th March 2011. Ruptured ACL, PCL and LCL playing football. Damaged peroneal nerve and have resulting foot drop since. Operation done 27th of June 2011. What do u think about the ability of the nerve to improve itself? reasonable improvement in last 8 months (from 0 to maybe 50% dorsiflexion and eversion of ankle) any answers from docters or specialists Re: the nerve have not been optimistic. Any chance going back to sport in future?
It’s been 8 years. Do you still play?
How's your knee now? Curious cause I'm facing the same issue.
Yea I use an AFO
my fibula often dislocates is painful then i pop it back in. it happens when i cross my knee then move i need to know how to fix this please. its sad to face reality that i have messed up knees at a young age im only 15.
I just dislocated mine while picking up my niece, and I don't care what anyone says..the pain was 10/10. I was like that for almost 2 hours before I could get help and the paramedics won't give you anything for pain. The doctor didn't either-they reset my knee and then gave me pain meds...Just how it went for me. they never checked my pedal pulses...which now makes me wonder...
+Rachelle Hermanson Yeah the pain is quite bad and I just dislocated my knee yesterday . Now it's swelling up to double my knee size and it's been my 7th time I've dislocated my knee
Rabid Rabbit WOAH This is late but 7 times? You had to have surgery! I only dislocated it once and if I dislocate it again I have to do surgery.
I dislocated my kneecap in my dance class when i was doing a jump,the medics put it back in. That was four months ago and I didn't to anything Physical for two months, I am back to dance now and have had Phisio, but still hurts when I am even sitting and sometimes put strains on it in dance. Wear supports for running and dance, should I be worried about it dislocating again? Seeing as I do dance classes nearly everyday?
Did u dislocate it again?
@HeartBreakProuductions Me Too!
i had my knee rotating twice didnt dislocate but i coudltn move my leg for 2 minutes
2min of pain from hell
should i visit a doctor or no point :\?
I don’t know what my condition is, it happened to all of my ancestors. My knee dislocates for a split second and I can’t predict when. I grew up with it but it still it sometimes give me an unpleasant surprise. So that is the reason why I am extremely afraid to run since i might fall ANYtime. I really need help.
My knee is dislocated right now no blood flow no one around to help. It happens way to often and now it wont go back in place
I have dislocated my left knee yesterday, it was the most traumatic and painful thing I've ever went through, I have crutches now...
The painfulest thing ever....
But then when I had that Tonic Clonic 😐
I dislocated my knee and damaged the ACL, PCL, MCL and torn my LCL. My surgeon recommended a surgery ASAP but my knee is too swollen so I'm going for physio everyday to get the knee bend. I'm so scared and I have no idea what to do , what do you recommend?
Did u have ur surgery
Same thing happened with me
Can we contact each other please 🙏
Don't worry people , dislocating ur kneecap is nothing scary it hurts but u can't do anything about it just reduce it as fast as u can before ur muscles contract to avoid more pain , I'm got hypermobility - my ligaments are very weak and I've dislocated both of my knees about 20 odd times and I still compete in badminton competitions, play netball , ski , swim . The fact that u dislocate ur leg doesn't restrict anything , all u have to do is to excercise to avoid or reduce nxt dislocations
can bend 100%???
😰😰😰 does this mean I only have one ligament holding my knee?
Will dislocated knee affect my future performance in sports? It popped out and back in in a split second
Mohamed El Fangary something like that wouldn't be very likely to cause permanent damage. But I would still be carefull ive dislocated my knee's multiple times im only 12 and every step I take is pain.
Ig everyone's case is different. Since I have dislocated my knee several times on my right knee I don't feel pain on it anymore but I still have that feeling when your knee dislocates and can't even walk properly for the rest of the day. I recently dislocated my left knee and it popped right back to it's place. The other times I've dislocated my left knee, it was minor so the pain was like a sting and I would be able to walk properly again in like 2 hours. But a few months ago I couldn't walk properly until 2 days later. I hit my knee on the edge of the desk so that's why. It usually happens when I walk or run wrong. I've been having hip, thigh and knee pain recently since the first dislocation. At first it was just my knee, as the years went by the pain would get worse and it slowly went on my hips and then thighs too and more recently sometimes I have to sit down because I'm not able to walk properly because of the pain.
It happened to me but i didnt fell a lot of pain cuz it popped back right back almost instantly
@thomas67129 will help
I wish I would have watched this 4 days ago.. knee has been dislocated that whole time and now I gotta wait until morning to scoot down to my car and go to the hospital once the sun comes up in 6hrs.. most painful thing I've ever experienced
First time i got it, the medial one and i know the cause in which i've learned from... i pray it never happens again
did it happen again??
What if you dislocate it but it like it shifts for a split second and gets back in place? It hurts like hell
That had happened to me 4 times
That’s what happened to me today and idk if I should still go to wrestling tomorow
Happens to me often which is why I don't feel pain on my right knee anymore but there's still fear
men when i saw the graphics of the dislocation man i just felt the pain right away it hapen to me twice once every leg... trust me it hurt
I have dislocated both of my knees several times a week since I was in fourth grade, and I am now a junior in high school. At the slightest loss of balance, one of my knees will dislocate. They always fall back into place on their own, so this usually just causes me to have steeling and pain in walking for a few days. However, I have to take gym class this year at school and I worry that my knees will dislocate and this school year will be a painful one. Does anyone have any tips?
horsesrmylife78 since its been 3 years, how did Junior year go?
I dislocated both of my knees (not at the same time but months later) and my doctor does not know why is happen. Most people say that i did a vary violent move like the video says but it they both happen when i was standing!? My family and my doctor thinks it happens because of my excessive growth ( I am taller than i am suppose to be for my age and my doctor told me that i was gonna be as tall as 6'5 or so ) and not giving my muscles time to stretch like my bones did (My bones are perfectly fine they are strong and healthy) I'm not sure if its a condition or something but can anyone help me find out why do my knees dislocate for no reason?
Cristina Garcia same problem dear😭😭
I have a syndrome which gives me weak and undeveloped legiments, it fucking hurts
Dang now I fully understand I dislocated my knee last year and tore my ligaments and almost got an amputation 😲 To this day I'm still struggling trying to walk and exercise but thank god and the doctors I didn't. 😞
The doctor was suggesting for my knee to get amputated luckily they didn't do it because I was scared.
Fourth dislocation this am
yeah, i did this like 8 weeks ago and broke to flakes of bone off with the dislocation and wouldn't have healed without a knee support but im still going through therapy
Having knee pain i screamed mom came and she place the thing back in its position and ta-da i am running rn ....Mom is true blessing❤
I dislocated both of my knees my sport dreams are over
Tell me about it, plus ligament tears
mine also i cant do one of my sports now
I dislocated mine 6 times and continue to try to play sports
Me too both dislocated I’ve done 7 operations in both of them and waiting for other one
i dislocated my platella in 2015 in scotland and i didnt take a ambulance i toke a taxi to the hospital it was 20 to 30 minutes before mine was fixed i got to the hospital they saw me gave me laughing gas for the pain and reset it
then i got an x-ray i want to move to scotland their emergency healthcare is better than ours.
i dislocated my knee yesterday but luckily it was only out for a split second, i think the fall put it back in, but when it happened it only hurt for about 30 mins afterwards, during that time i dialed 999 and they arrived and told me that it want dislocated even though i thought i did, the pain isnt as bad today but it still hurts to walk on it, does anyone know if it does sound like a dislocation or anything?
Danny Johnston yes. I've dislocated my left knee twice, the first time I was walking and it was out for about an hour before the doctors moved my leg for an xray and it went back in. the second time I went to sit down in class and it popped out and went right back in. if it popped out. there would be a large fluid sack around your knee cap area that would drain (hopefully) over time. if there is, I'd suggest to be on crutches for as long as it doesn't hurt, and to see your doctor asap
Danny Johnston Hi that happened to me all the time before I actually dislocated it, It basically pops out but it's not dislocated, you really need to check it out before you actually do, btw just do some knee exercises.
Danny Johnston that’s a subluxation
Mine popped in, sometimes it pops out too tho
i dislocated my left knee 2 months ago while playing monkey bars i fell and the medics put it back in place and i did it again today while dancing when i was cleaning on the same knee it hurts soo bad and the doctors who helped put it back told me i had to check up with the specialist they gave after a week im scared it will happen again what can i do to prevent it. because it happens so easily when pressured the tiniest bit
Alina Mukova knee brace
Eas coast. i have one on already i was wondering how long will it take till fully recovered and wont happen again even if i fall or put pressure on it and after starting walking does it mean you can exercise and how long do i wear the
knee brace
wear a knee sleeve when running or doing an exercise but make sure your knee is not in pain b4 going with out any brace or knee sleeve
Alina Mukova I wud recommend a copper fit knee sleeve and after an exercise to put ice on to keep cool and to reduce swelling
My knee was dislocated :(
I dislocated my knee this morning for the first time and it hurts like a b****
I dislocated my knee but I haven't torn a ligament
★Hige-San that's sad...Did you have surgery?
the sound of thunder ive dislocated my left knee twice, I'm fifteen. I have to get surgery as soon as I'm done growing that will most likely cut off parts of my bones and shit
★Hige that's why I have to wait until I'm done growing.
Your ligaments tear when you dislocate your knee
I was at basketball practice wen it happen,that shit hurts
I dislocated my knee 4 months ago while I was in a basketball match i am recovering now. Since it has been 6 years when you dislocated it how are you now. Please reply.
U should be fine , ur chuck norris after all
Your ligaments don’t actually rupture in 2 lol they strain or tear
I feel lucky that I only ruptured my ACL
Lol dude...
Anyone panicking about it don't! I dislocated my knee 2weeks ago playing basketball and being as skinny as I am it was pressed right up to my skin, like it was about to burst through... Even the look of it put me into shock which meant I could hardly feel it.. Then paramedics give you what u need so you don't feel a thing anyway... Dislocating your knee really aint that bad.
wow you done your knee playing basketball i picked up a fucking pencil and done mine :(
James Townsmen I was walking after I made the basket when mine popped out the first time
James Townsmen What ligaments did you tear??