10-Year review of knee dislocations

Is arteriography always necessary?

Jeffrey D. Hollis, Brian Daley, Sherry M. Melton, Jesse A. Blumenthal, Jeffrey D. Hollis

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background: Historically, arteriography has been used routinely in patients with knee dislocations. Recently, selectivity based on physical examination (PE) has emerged. Critics cite limited clinical evidence. We sought to determine whether PE accurately confirms or excludes surgically significant vascular injuries associated with knee dislocations. Methods: We conducted an institutional review board-approved retrospective review of patients admitted at a university-based Level I trauma center with knee dislocations from January 1, 1993, to December 31, 2002. Thirty-nine patients (28 male patients and 11 female patients; average age, 42.8 years) had 39 dislocations (27 left and 12 right, 26 posterior and 13 anterior). Most patients (n = 25) were involved in motor vehicle crashes. All patients underwent arteriography. Results: Of the 20 normal arteriograms, all had normal PE. Of the 19 abnormal arteriograms, 8 had a normal PE and 11 were abnormal. Within this subgroup, none of the 8 with normal PE required surgery, whereas 7 of the 11 with abnormal PE required surgery. None of the nonoperative patients had vascular complications during the hospital stay. Sensitivity and specificity were 100% for PE on surgically significant vascular injury. Conclusion: Routine arteriography is unnecessary in patients with a normal PE after reduction of the knee dislocation.

Original languageEnglish (US)
Pages (from-to)672-676
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume59
Issue number3
DOIs
StatePublished - Sep 1 2005

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Knee Dislocation
Angiography
Physical Examination
Vascular System Injuries
Trauma Centers
Research Ethics Committees
Motor Vehicles
Blood Vessels
Length of Stay

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

10-Year review of knee dislocations : Is arteriography always necessary? / Hollis, Jeffrey D.; Daley, Brian; Melton, Sherry M.; Blumenthal, Jesse A.; Hollis, Jeffrey D.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 59, No. 3, 01.09.2005, p. 672-676.

Research output: Contribution to journalArticle

Hollis, Jeffrey D. ; Daley, Brian ; Melton, Sherry M. ; Blumenthal, Jesse A. ; Hollis, Jeffrey D. / 10-Year review of knee dislocations : Is arteriography always necessary?. In: Journal of Trauma - Injury, Infection and Critical Care. 2005 ; Vol. 59, No. 3. pp. 672-676.
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