A Two-stage procedure for the treatment of a neglected posterolateral knee dislocation: Gradual reduction with an Ilizarov external fixator followed by arthroscopic anterior and posterior cruciate ligament reconstruction

• Neglected knee dislocations are extremely uncommon.
• Vascular and nerve damage accompany the dislocation in many patients.
• Two-stage procedures could be used for the treatment.
• First stage: gradual reduction using the Ilizarov technique
• Second stage: arthroscopic ligamentous reconstruction

BackgroundNeglected knee dislocations are extremely uncommon and their management cannot be evidence-based since only a few case reports have been published describing different treatment methods. We present the case of a young man with a neglected posterolateral knee dislocation and a concomitant sciatic nerve injury.MethodsA two-stage treatment strategy with gradual reduction using the Ilizarov technique and subsequent arthroscopic anterior and posterior cruciate ligament reconstruction was followed.ResultsThe two-stage treatment approach led to a satisfactory clinical outcome. At the latest follow-up evaluation the patient was fully ambulatory and the knee was painless with no anteroposterior instability.ConclusionsIn neglected knee dislocations treatment optios are guided by the severity of the concomitant injuries and the status of articulating surfaces. Gradual reduction with the Ilizarov technique and subsequent arthroscopic ligamentous reconstruction is a reliable alternative to open surgical procedures.