Complex Knee Ligament Injury & Knee Dislocation Program
Complex knee ligament injuries occur when athletes or patients sustain severe trauma, injuring two or more ligaments in or around the knee. In these cases, surgery is typically needed to repair or reconstruct these important structures. Without this surgery, the knee has potential for being unstable with simple daily activities or athletic pursuits. There is also risk of premature arthritis secondary to the abnormal motion of the knee joint.
These injuries can occur during athletics and collision sports, or traumatic events such as falls from heights, or motorcycle or automobile injuries.
The most severe of these injuries, a knee dislocation, is typically the result of a high-energy injury resulting in disruption of the normal alignment of the thigh (femur) and the shin (tibia) bones. Unfortunately, these are injuries that can cause both neurologic or blood vessel injuries and can be limb-threatening emergencies. Knee dislocations are fortunately rare, accounting for 0.02-0.2% of all musculoskeletal injuries.
A thorough and accurate diagnosis is critical in treating these complicated knee injuries. Proper diagnosis, including identification of the torn ligaments as well as assessment of the location of the tear and associated injuries, is one of the primary challenges with treatment of these injuries. While high-resolution MRI is a critical diagnostic tool, the ability to quickly and accurately diagnose these injuries requires the surgeon to have excellent knowledge of the complex function of the knee ligaments and skilled physical examination techniques. Combined with the MRI images, this allows for an individualized treatment plan for these unique injuries.
Through our involvement with Yale New Haven Hospital’s Level 1 Trauma Center program, our orthopaedic and trauma surgeons have developed extensive experience with these injuries over the past 20 years. Our orthopaedists work closely with our general surgery trauma, vascular surgery, plastic surgery and expert musculoskeletal radiology colleagues in order to care for these potentially limb-threatening knee injuries. Prompt diagnosis is of highest importance and we accept referrals and transfers from all outside facilities, which can be arranged through our Yale New Haven Hospital Y Access program (888-YNHH-BED). Patients are occasionally “life flighted” via SkyHealth from outside facilities by helicopter to be treated at our tertiary care center. SkyHealth travels within a 200-mile radius of New Haven.
Our team also works closely with affiliated physical therapists who are trained in the management of patients in their recovery phase of healing. As these injuries and procedures are uncommon, a carefully structured rehabilitation program guided by experiences physical therapists is also crucial to patient recovery.
Depending upon the clinical situation, care is either performed in an inpatient setting at Yale New Haven Hospital’s York Street campus, or the patient receives outpatient evaluation and then surgical treatment at the McGivney Advanced Surgery Center or Greenwich Hospital. Patients receive concierge-style care, which allows for as stress-free a surgical experience as possible. Patients are cared for by Yale’s board-certified and fellowship-trained surgeons and anesthesiologists, physician assistants, as well as highly trained nurses and physical therapists.
The facilities at the McGivney Advanced Surgery Center in New Haven and Greenwich Hospital allow our surgeons to provide state-of-the-art, cutting-edge surgical treatments in order to give patients the best potential for maximal recovery.
After surgery, our experienced physical therapists will work closely with these injured patients to guide them through the sometimes-difficult recovery phases of rehabilitation.
In order to further the knowledge base of this complicated and uncommon knee injury, retrospective studies have already been undertaken and prospective studies are underway at Yale. We encourage patients to participate in these outcome studies in order to assist future patients who may sustain these severe knee injuries.