How I Manage the Multiple-Ligament Injured (Dislocated) Knee

The multiple ligament injured knee, or the dislocated knee remains a challenge for any orthopedic surgeon because of the high risk of associated neurovascular injury and potential devastating consequences including loss of limb. Although there are several principles that guide management, optimal treatment strategies remain controversial. Each individual patient and each knee injury is unique; therefore, it is very difficult to perform evidenced-based research because in this heterogeneous patient population. Surgical decision making is influenced by the specific knee injury pattern, but also by the associated polytrauma that these patients sustain from high-energy motor vehicle or motorcycle collisions. Our approach to the dislocated knee is based upon the responses to numerous questions. This review will shed some light on the questions we ask and how treatment decisions are made.