A dislocated knee represents a severe injury where the bones forming the knee joint are forced out of their normal alignment. Such an injury is rare but can lead to significant damage to surrounding structures, including ligaments, blood vessels, and nerves. Understanding the appropriate immediate actions is important given the potential for serious complications and the need for prompt medical attention.
Identifying a Knee Dislocation
Recognizing a knee dislocation involves distinct signs. A true knee dislocation, medically known as a tibiofemoral dislocation, occurs when the shinbone completely displaces from the thighbone at the knee joint. This is a medical emergency often resulting from high-energy trauma, such as car accidents or severe sports injuries. The knee may appear visibly deformed or crooked, with intense pain, swelling, and an inability to move or bear weight. Sometimes, a “popping” sound is heard at the time of injury.
A patellar, or kneecap, dislocation is a different, less severe injury, though still painful. This occurs when the kneecap (patella) moves out of its groove at the front of the knee. While a patellar dislocation can also cause visible displacement, swelling, and difficulty straightening or bending the leg, it often results from a sudden twist or direct blow, particularly in sports. Unlike a true knee dislocation, a dislocated kneecap may sometimes spontaneously return to its correct position, though medical evaluation remains necessary.
Essential First Aid Steps
If a knee dislocation is suspected, immediate and appropriate first aid can help prevent further harm before professional medical help arrives. Contact emergency services (e.g., 911) immediately, as prompt medical evaluation is crucial.
It is important to avoid attempting to put the knee back into place. Manipulating a dislocated joint can cause additional damage to surrounding tissues, including nerves and blood vessels. Instead, immobilize the leg in the position it was found. Use supportive materials like rolled clothing or magazines to create an improvised splint above and below the injured knee.
Applying ice packs indirectly to the injured area can help reduce pain and swelling. Place a thin cloth between the ice and the skin to prevent frostbite. Elevating the injured leg, if possible and comfortable for the individual, can also help minimize swelling by promoting fluid drainage. Keeping the person calm and still, and covering them with a blanket to prevent shock, are also helpful measures while waiting for paramedics.
Receiving Emergency Medical Treatment
Upon arrival at the emergency room, a physician will conduct a thorough physical examination to assess the injury’s extent and check for any associated damage. This includes evaluating pulses in the lower leg and foot to detect potential blood vessel injuries, a serious concern with knee dislocations.
Diagnostic imaging, such as X-rays, confirms the dislocation and identifies fractures. Magnetic resonance imaging (MRI) or computed tomography (CT) scans may also assess damage to ligaments, cartilage, blood vessels, and nerves.
The process of realigning the dislocated joint, known as reduction, is typically performed by a doctor under sedation or anesthesia to manage pain and muscle spasms. This procedure should only be done by a trained physician due to the risk of complications.
What to Expect in Initial Recovery
Following reduction, immediate care focuses on stabilization and initial healing. The knee is typically immobilized in a brace or cast for several weeks to allow tissues to heal. Pain management, including medication, is provided as needed.
Follow-up appointments with orthopedic specialists monitor healing and assess for complications. It is important to watch for signs of potential issues, such as increased pain, numbness, tingling, or coolness in the foot, as these could indicate nerve or blood vessel compromise. While physical therapy will be a significant part of the long-term rehabilitation, the initial recovery period emphasizes rest and protection of the injured joint. Crutches are often necessary to avoid putting weight on the knee during this initial phase.