Introduction. It is now widely accepted that acute knee dislocations should be managed operatively. Most published studies are from outside the UK and from major trauma or specialist centres. The aim of the study is to report the functional outcomes of all patients presenting with an acute knee dislocation at our institution all of whom were surgically managed. The results were then compared to other published series. The hypothesis being that there would be no significant difference in the functional outcome scores between the groups. Methods. All patients presenting with an acute knee dislocation over the last 15 years were included in the study. The patients were followed up using functional assessment scores: Knee outcome score (ADL), Knee outcome score (sports), Tegner Lysholm Scores and overall Patient Satisfaction. The patients were classified according to the Schecnk classification of knee dislocations. Results. There were 22 patients in total, 21 male and 1 female. Average age was 42 years (range 16-54 years). The mean follow up was 6.3 years (range 1-15 years). The mean Knee Outcomes Score for ADL was 86% (68-100) and for Sports was 84% (44-100). The mean Tegner Lysholm Score was 82% (59-91) and the Overall Patient Satisfaction mean score was 77% (60-95). These results are comparable to other published data with no significant difference between the groups. Conclusion. Satisfactory functional results can be obtained for surgically treated acute knee dislocations in a UK non-specialist centre

Purpose. To study the initial presentation and subsequent investigation and management of acute knee dislocations at a regional trauma centre. Introduction. Knee dislocation requires high energy trauma, and often affects young working adults. The high incidence of associated arterial, neurological, ligamentous, and other soft tissue injuries, can produce potentially devastating outcomes. Rapid mobilisation of traditionally distinct surgical teams, with urgent vascular imaging and emergency surgery are often necessary. The extent and severity of ligamentous damage may require multiple operations to repair. Methods. A retrospective nine-year study of knee dislocations managed in the Trauma and Orthopaedic Department of the Royal Hospitals, Belfast was performed using a Fractures Outcomes Research Database (FORD), a chart review, and a review of relevant radiology. Demographic data, mechanisms of injury, associated neurovascular injuries, ligamentous damage, and operative intervention were recorded. Results. 15 patients were identified over 9 years (2000-2008 inclusive). Mean age at injury was 38 years, median 37. 14 (93%) of patients were male, 1 (7%) was female. 6 injuries (40%) were sport-related, 3 (20%) occurred as a result of road traffic collisions, 5 (33%) were accidents in the workplace, and 1 (7%) was a result of a fall while intoxicated with alcohol. 5 (33%) patients experienced a common peroneal nerve palsy. 10 (67%) received vascular imaging, and 2 (13%) underwent vascular surgery as part of the initial theatre episode. All 15 dislocations led to some degree of structural soft tissue knee injuries. These included 12 (80%) anterior cruciate ligaments, 8 (53%) posterior cruciate ligaments, 7 (47%) lateral collateral ligaments, and 5 (33%) medial collateral ligaments. 3 posterolateral corner injuries required repair. Of the 15 patients, 2 (13%) underwent no operative procedures following closed reduction, and the remaining 13 patients had 21 distinct theatre episodes recorded between them. 2 fasciotomies for compartment syndrome, and 2 common peroneal nerve decompression/explorations were performed in the initial theatre episode. 3 patients (20%) were managed with an external fixator initially. 1 patient (7%) developed complications and required trans-femoral amputation. Conclusions. Knee dislocation remains uncommon, and even major centres may receive only a few injuries per year. Orthopaedic, Vascular and Plastic surgeons, as well as Emergency Physicians and Radiologists must remain vigilant to the challenge which this injury can present, and the opportunity for excellent outcomes through a coordinated approach with close communication, awareness of injury patterns, and availability of theatre and imaging resources