Subacute High-Energy Traumatic Knee Dislocation in an Ambulatory Patient

2019 ◽  
Vol 9 (4) ◽  
pp. e0258-e0258
Author(s):  
Elise Britt ◽  
D.C. Covey
2013 ◽  
Vol 57 (5) ◽  
pp. 1196-1203 ◽  
Author(s):  
Andrew G. Georgiadis ◽  
Farah H. Mohammad ◽  
Kristin T. Mizerik ◽  
Timothy J. Nypaver ◽  
Alexander D. Shepard

2020 ◽  
Vol 33 (04) ◽  
pp. 351-356 ◽  
Author(s):  
James P. Stannard ◽  
Anna J. Schreiner

AbstractKnee dislocations (KDs) are frequently found in high-energy impact injuries, ranging from automobile accidents to contact sports. KDs require careful examination due to the limb-threatening nature of these injuries. A key examination in any KD comprises a proper assessment of the vascular status. The risk of popliteal artery injury with a KD has varied from 7 to 40%, with more contemporary studies reporting injury in the range of 7 to 15%. The notion of mandatory emergent arteriography was challenged in the trauma literature as several small retrospective studies suggested that selective arteriography was a safe and effective treatment protocol. New imaging modalities have evolved and have found their way into trauma surgery. Computed tomography angiography and magnetic resonance angiography are two contemporary imaging modalities that have different characteristics as well as availability. Arteriography has been the gold standard and is a reliable and proven method of evaluation. However, it has a number of negative aspects that must be considered when determining the ideal imaging for a patient following KD. Besides cost savings of about more than US$500,000, conventional arteriography, which comprises the use of X-ray, arterial puncture and cannulation, and the use of contrast agents containing iodine, has got a complication rate as high as 9% and more patient discomfort compared with the new imaging modalities. This clinical practice review documents that our algorithm of clinical examination first combined with advanced imaging in cases with abnormalities documented on examination is a safe and prudent policy in treating patients following KD.


2022 ◽  
Vol 15 (1) ◽  
pp. e247173
Author(s):  
Paul Andre Paterson-Byrne ◽  
William Thomas Wilson ◽  
Graeme Philip Hopper ◽  
Gordon M MacKay

Multiligament injury of the knee usually occurs as a result of high-energy trauma causing tibiofemoral dislocation. These are rare but potentially limb-threatening injuries, frequently involving nerve or arterial damage and often leading to severe complex instability. Management generally favours surgical reconstruction of the affected ligaments, with controversy regarding optimal treatment. We present a severe multiligament knee injury (Schenk classification KD-IV involving both cruciate and both collateral ligaments) in a competitive showjumper. A combined arthroscopic/open technique of single-stage surgical repair and suture augmentation was used, repairing all affected ligaments. The patient made an excellent recovery, returning to work after 12 weeks and riding after 22 weeks. After 5-year follow-up, she has regained her previous level of competition without subsequent injury. Multiligament repair with suture augmentation is a viable approach to the management of knee dislocation injuries. We propose that this could provide superior outcomes to traditional reconstruction techniques using autograft or synthetic reconstruction.


2010 ◽  
Vol 2 (1) ◽  
pp. 7 ◽  
Author(s):  
Mohammed Fahd Amar ◽  
Badr Chbani ◽  
Oussama Ammoumri ◽  
Amine Marzouki ◽  
Fawzi Boutayeb

Knee dislocations are rare injuries. They represent a severe soft tissue injury following high-energy blunt trauma. We report a case of open posterior knee dislocation with rupture of the patellar tendon and a fracture of the tibial plateau. The treatment was surgical and consisted of reduction of the knee dislocation, fixation of the tibial plateau fracture by lag screws, and transosseous sutures for the patellar tendon protected by a patellotibial cerclage. The result was successful with full range of motion.


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Serdar Yilmaz ◽  
Deniz Cankaya ◽  
Alper Deveci ◽  
Mahmut Ozdemir ◽  
Murat Bozkurt

An increasing number of patients with hip fracture have been seen with osteoporosis associated with osteoarthritis. Although knee dislocation is related to high-energy trauma, low-grade injuries can also lead to knee dislocation which is defined as “ultra-low velocity dislocation.” The case reported here is of an 82-year-old patient who presented with a left intertrochanteric hip fracture. Partial arthroplasty was planned because of osteoporosis. In the course of surgery, degenerative arthritic knee was dislocated during the hip reduction maneuver with the application of long traction. The neurovascular examination was intact, but the knee was grossly unstable and was dislocated even in a brace; thus a hinged knee prosthesis was applied nine days after surgery. The patient was mobilized with crutches after the knee prosthesis but exercise tolerance was diminished. In conclusion, it should be emphasized that overtraction must be avoided during the hip reduction maneuver in patients with advanced osteoarthritic knee.


2012 ◽  
Vol 56 (4) ◽  
pp. 1189
Author(s):  
Andrew G. Georgiadis ◽  
Farah H. Mohammad ◽  
Kristin T. Mizerik ◽  
Timothy J. Nypaver ◽  
Alexander D. Shepard

1984 ◽  
Vol 75 ◽  
pp. 599-602
Author(s):  
T.V. Johnson ◽  
G.E. Morfill ◽  
E. Grun

A number of lines of evidence suggest that the particles making up the E-ring are small, on the order of a few microns or less in size (Terrile and Tokunaga, 1980, BAAS; Pang et al., 1982 Saturn meeting; Tucson, AZ). This suggests that a variety of electromagnetic and plasma affects may be important in considering the history of such particles. We have shown (Morfill et al., 1982, J. Geophys. Res., in press) that plasma drags forces from the corotating plasma will rapidly evolve E-ring particle orbits to increasing distance from Saturn until a point is reached where radiation drag forces acting to decrease orbital radius balance this outward acceleration. This occurs at approximately Rhea's orbit, although the exact value is subject to many uncertainties. The time scale for plasma drag to move particles from Enceladus' orbit to the outer E-ring is ~104yr. A variety of effects also act to remove particles, primarily sputtering by both high energy charged particles (Cheng et al., 1982, J. Geophys. Res., in press) and corotating plasma (Morfill et al., 1982). The time scale for sputtering away one micron particles is also short, 102 - 10 yrs. Thus the detailed particle density profile in the E-ring is set by a competition between orbit evolution and particle removal. The high density region near Enceladus' orbit may result from the sputtering yeild of corotating ions being less than unity at this radius (e.g. Eviatar et al., 1982, Saturn meeting). In any case, an active source of E-ring material is required if the feature is not very ephemeral - Enceladus itself, with its geologically recent surface, appears still to be the best candidate for the ultimate source of E-ring material.


Author(s):  
J. B. Warren

Electron diffraction intensity profiles have been used extensively in studies of polycrystalline and amorphous thin films. In previous work, diffraction intensity profiles were quantitized either by mechanically scanning the photographic emulsion with a densitometer or by using deflection coils to scan the diffraction pattern over a stationary detector. Such methods tend to be slow, and the intensities must still be converted from analog to digital form for quantitative analysis. The Instrumentation Division at Brookhaven has designed and constructed a electron diffractometer, based on a silicon photodiode array, that overcomes these disadvantages. The instrument is compact (Fig. 1), can be used with any unmodified electron microscope, and acquires the data in a form immediately accessible by microcomputer.Major components include a RETICON 1024 element photodiode array for the de tector, an Analog Devices MAS-1202 analog digital converter and a Digital Equipment LSI 11/2 microcomputer. The photodiode array cannot detect high energy electrons without damage so an f/1.4 lens is used to focus the phosphor screen image of the diffraction pattern on to the photodiode array.


Author(s):  
J. M. Oblak ◽  
W. H. Rand

The energy of an a/2 <110> shear antiphase. boundary in the Ll2 expected to be at a minimum on {100} cube planes because here strue ture is there is no violation of nearest-neighbor order. The latter however does involve the disruption of second nearest neighbors. It has been suggested that cross slip of paired a/2 <110> dislocations from octahedral onto cube planes is an important dislocation trapping mechanism in Ni3Al; furthermore, slip traces consistent with cube slip are observed above 920°K.Due to the high energy of the {111} antiphase boundary (> 200 mJ/m2), paired a/2 <110> dislocations are tightly constricted on the octahedral plane and cannot be individually resolved.


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