Abstract
Irreducible posterolateral dislocations of the knee are rare lesions, generally caused
by high-energy trauma inducing rotational stress and a posterior and lateral displacement
of the tibia.
In these conditions, the interposition of abundant soft tissue inside the enlarged
medial joint space prevents spontaneous reduction or non-surgical treatment by manipulation
of the dislocation. Surgical treatment is therefore compulsory.
We report the clinical case of a woman who suffered a subluxation of the knee while
jogging. The case we describe is of interest because it shows that even less severe
knee dislocations, like this subluxation caused by a low-velocity sports trauma, may
present in an irreducible form requiring open surgery. Clinical-instrumental monitoring
did not reveal any signs of vascular or nerve injury. Owing to the irreducibility
of the lesion we were obliged to perform open surgery in order to free the joint from
the interposed muscle tissue and repair medial capsule-ligament lesions. Repair of
the damaged cruciate ligaments was deferred to a second stage, but ultimately rendered
necessary by the persistence of joint instability and the need to address the patient’s
functional needs. In the literature, different one- and two-step surgical options,
performed by arthroscopy or arthrotomy, are reported for such related problems.
The Authors discuss these various options and examine and discuss their own decision
taken during the surgical work-up of this case.
Key Words
knee - posterolateral - dislocation - anterior cruciate ligament - injury
