Dislocated Knee Surgery 101 : A Comprehensive Guide

Imagine the sudden, searing pain of your knee wrenching out of place. This is a knee dislocation – a traumatic injury that demands urgent attention. As you face this challenging journey, questions flood your mind: What exactly happened? How long until I can walk normally again? Will I ever regain my full strength and mobility?

Your path to recovery starts with understanding dislocated knee surgery, a procedure that mends damaged ligaments and restores stability to your knee. Your surgeon may recommend different techniques based on your specific injury, but every journey begins with a thorough assessment. This evaluation does more than just diagnose – it empowers you to have meaningful discussions with your healthcare provider, make informed decisions about your treatment, and actively shape your recovery plan.

Let this guide be your companion through the recovery process. You’ll learn about knee dislocations, explore your surgical options, understand rehabilitation strategies, and discover proven ways to regain full knee function after surgery. With knowledge as your foundation, you’re better equipped to tackle each step of recovery and emerge stronger than before.

Understanding Knee Dislocation

The knee is made up of bones, cartilage, ligaments, and tendons. As the largest joint in your body, your knee connects your femur (thigh bone) to your tibia (shin bone). These bones stay aligned through a complex network of ligaments, which can be damaged during a knee dislocation.

Four main ligaments hold your femur and tibia together: 

• Anterior cruciate ligament (ACL) 
• Posterior cruciate ligament (PCL)
• Medial collateral ligament (MCL)
• Lateral collateral ligament (LCL)

When these ligaments are damaged, your knee can dislocate — meaning the bones are pushed or bent out of place. This often happens during accidents, falls, or sports injuries that tear multiple ligaments at once. When two or more ligaments tear completely, doctors call it a multiligamentous knee injury. In severe cases, says John Grant, MD, Ph.D., clinical associate professor of orthopedic surgery at Michigan Medicine in Ann Arbor, Mich., the femur and tibia become completely separated. About half of patients with knee dislocations need their bones realigned in the emergency department.

As a traumatic injury, knee dislocation can damage arteries and nerves, sometimes severely enough to require amputation. Most cases require surgery to repair the damage.

It’s important to note that knee dislocation differs from a dislocated kneecap, known as the patella. Your kneecap sits at the front of your knee and normally glides up and down in the trochlear groove during daily activities like walking, sitting, and standing. The kneecap can slip out of this groove due to falls, direct hits, or even twisting movements during activities like dance or basketball. Some people are more prone to kneecap dislocation because of their natural anatomy.

Symptoms and Diagnosis of a Dislocated Knee 

A dislocated knee is a severe injury that causes intense pain, ranging from sharp sensations to deep, radiating aches throughout the leg. If you suspect you’ve dislocated your knee, seek immediate medical attention to prevent further damage and ensure proper treatment. Prompt professional intervention is crucial for optimal recovery and long-term knee function. 

While pain is a primary symptom, you may also experience:

• Bruising
• Feeling a “pop”
• Instability when walking or the inability to walk
• A deformed-looking knee
• Numbness and paleness of the lower leg (indicating artery or nerve damage)
• Pain and tenderness
• Problems with range of motion of the knee 
• Swelling

Recognizing these symptoms early can help you get the urgent care needed to protect your knee’s long-term health. Remember: The sooner you seek treatment, the better your chances for a full recovery.

Emergency Management of a Knee Dislocation

While they may seem rare, knee dislocations occur more frequently than many people realize. For about 50 percent of people who have a knee dislocation, they arrive at the emergency department with their knee back in place, says Dr. Grant. 

No matter if your knee is in or out of alignment, you need immediate medical care. Knee dislocation is a serious injury. In the meantime, use the acronym RICE to guide your immediate care:

• R: Rest. Your knee will likely be painful and unstable, so avoid bearing weight on it or walking.
• I: Ice. Icing the injured knee joint can help reduce swelling.
• C: Compress and call emergency services. While C typically refers to compression, in this case, you should also call 911. Knee dislocation requires emergency care to check for dangerous complications, such as blood vessel or nerve damage.
• E: Elevation. Place two to three pillows under your foot to help reduce swelling.

While following these steps can help manage your injury initially, they’re not a substitute for professional medical care. Getting prompt treatment at an emergency department gives you the best chance for proper healing and can prevent serious complications that might occur without expert intervention.

How dislocated knee is diagnosed

If you notice any signs of a knee injury, especially after a fall or accident, don’t wait to get help. Even if your knee looks normal, it’s crucial to have it checked right away. Head to an emergency department or an orthopedic urgent care center immediately. Medical staff there have the tools and expertise to properly assess your knee and determine if it’s dislocated or has other damage.

While seeking immediate medical attention is crucial for any knee injury, it’s important to understand the difference between types of knee dislocations. A dislocated kneecap is less serious than a dislocated knee because it causes less damage to ligaments and is less likely to harm nerves and blood vessels.

However, don’t dismiss a kneecap injury. Even if the kneecap returned to place on its own or with assistance, you should still see a medical provider to check for additional knee injuries. Proper assessment can reveal hidden damage and prevent future complications.

Knee swelling and pain can make it challenging for your care provider to conduct a physical exam. Your provider will check knee stability and appearance, take the pulse behind the knee, and review your health history to better understand your injury. 

To confirm a dislocated knee, your provider may also recommend:

• An X-ray
• An ankle-brachial index measurement to detect blood vessel injury
• Other imaging, including a CT scan or MRI, which can identify the extent of injury, including fractures and damage to soft tissues, ligaments, and blood vessels

The results of these tests will help determine if your dislocated knee needs immediate surgery or if it can wait. If your knee can be realigned through a procedure called reduction and maintains adequate blood flow, you may delay surgery until swelling and inflammation subside. You and your provider will discuss the timing of any necessary surgery.

Treatment Options for a Dislocated Knee

Although surgery is the main treatment for a dislocated knee, it may not be the right choice for everyone and depends on the extent of the injury, knee structures affected, and soft tissue damage. Your treatment journey will be tailored to your specific situation, considering factors like your age, activity level, and overall health. It’s important to have an open dialogue with your healthcare team to understand the pros and cons of each option and how they align with your recovery goals and lifestyle. Here’s what your provider may recommend:

Non-surgical treatment options

If your tibia and femur are still disconnected — about half of patients arrive at the emergency department with their knee already in place — your provider will use a technique called a reduction to realign the knee or kneecap. After the reduction, you may receive medication to reduce pain and discomfort, depending on the severity of the injury.

After the reduction, you’ll be fitted with a splint to protect your knee. An immobilizer, a device that wraps around your knee to prevent movement, may also be used to support the joint. You’ll need to rest your knee until swelling and discomfort subside.

Rehabilitation is critical for good recovery, so make sure you connect with a physical therapist who can guide you through muscle strengthening, balance, and range of motion exercises. Ask your provider for a referral; they may recommend someone who specializes in knee injury and rehabilitation. Check your insurance benefits to see what coverage your plan offers and which specialists are in-network in your area.

Surgical treatment options

There are many types of surgery for knee dislocation. The complexity of these procedures reflects the intricate nature of the knee joint and the various ways it can be injured. Your surgeon will carefully evaluate your specific case to determine the most appropriate surgical approach. Your surgical plan will depend on several factors:

• The cause of the knee dislocation
• The extent of damage to bones and other knee structures
• Whether you’ve had recurrent dislocations
• Any artery or nerve damage

Surgical treatment options include meniscus repair, ligament reconstruction, osteotomy, and patellar realignment. It may be done as open knee surgery or minimally invasive arthroscopic surgery.

Timing of surgery is also important. There are pros and cons to immediate versus delayed surgery. This timing can affect long-term knee stability, stiffness, and range of motion, says Dr. Grant, who is currently leading research to determine optimal surgery timing. Additionally, surgery may be performed all at once or staged when more than one procedure is planned. Talk to your surgeon about how you can work together to make the right decision for you.

How to find the right doctor for dislocated knee surgery

When surgery becomes the recommended path for your knee dislocation, selecting the right care team is paramount. This decision can significantly impact your surgical outcome and overall recovery experience. While the prospect of surgery may feel daunting, remember that you’re in control of your healthcare choices.

Seek out a qualified surgeon to perform knee dislocation surgery. The surgeon should be a board-certified orthopedic surgeon who specializes in knee procedures. If you’re looking for an orthopedic specialist, Commons Clinic has expert physicians who provide knee dislocation and recovery care.

When deciding if the physician is a good fit, consider asking these questions:

• How many surgeries like mine have you done?
• What are the potential side effects and complications of this surgery, and what do you do to minimize these risks?
• What can I expect during recovery?
• How can I reach you if I have questions or concerns after surgery?
• Does the recommended surgery align with my recovery goals?

Types of Dislocated Knee Surgery 

Several surgical procedures can treat knee injuries like knee dislocation. The surgical approach depends on various factors, including any additional injuries, whether knee ligaments are torn or intact, and if you have a true knee dislocation or kneecap injury.

Ligament reconstruction

When one or more ligaments in the knee are torn beyond repair, reconstruction may be needed. During ligament reconstruction, the surgeon replaces the damaged ligament with a tissue graft from the patient’s own body or donor tissue. This is often done via arthroscopy, a minimally invasive surgical procedure where a surgeon inserts a fiber-optic camera through tiny incisions to visualize the knee and replace the ligaments.

Meniscus repair

The meniscus consists of two shock-absorbing cartilages that sit between the tibia and femur and help stabilize the knee joint. The cartilage can be damaged in knee dislocation injuries. Surgeons use minimally invasive arthroscopic surgery to repair or remove sections of the damaged meniscus.

Osteotomy surgery

In an osteotomy, the surgeon reshapes the tibia or thighbone to correct improper alignment and improve knee movement. This involves cutting away bone or adding a bone graft — transplanted bone from your own body or a human donor — depending on what your knee needs to regain function. The procedure changes how weight loads onto the knee, making movement more comfortable. Besides realigning the kneecap, osteotomy surgery often treats knee osteoarthritis and can delay the need for total knee replacement.

Patellar realignment surgery

For patellar dislocation, doctors may recommend patellar realignment surgery if nonsurgical options fail. This outpatient procedure realigns your kneecap to slide properly over the joint. The surgeon may tighten, release, or reconstruct connective tissues as needed to restore proper kneecap position.

Risks and Complications of Dislocated Knee Surgery

Surgery of any kind comes with the possibility of risks and complications, and knee surgery is no exception. Some of these complications are mild and will resolve on their own, while others are rare but very serious. It’s important to understand that the specific risks can vary depending on the type of knee surgery you’re undergoing and your overall health condition.

Having an open discussion with your care provider can help you understand your risks better and determine if your health history makes you more likely to experience complications. Talk to your surgeon about how to recognize signs of post-surgical complications, what to do if they occur, and when to call your provider:

• Bleeding
• Blood vessel injury
• Blood clots
• Compartment syndrome (a buildup of pressure in muscles that impairs blood flow) 
• Improper wound healing
• Infection
• Nerve injury
• Pain and stiffness
• Scar tissue formation

Working closely with your healthcare team before and after surgery helps ensure the best possible outcome. Your surgeon and care team will monitor your recovery progress and help you address any complications that arise, making adjustments to your treatment plan as needed to support your healing.

Rehabilitation and Recovery After Dislocated Knee Surgery

Rehabilitation following knee surgery is a critical component of a successful recovery. “A thorough course of rehab ensures that the knee regains the stability and strength, as well as form and function, that it needs,” says board-certified sports medicine specialist Moin Salah, M.D., MBA, medical director of clinical operations at Commons Clinic. 

Rehabilitation isn’t just one thing; it involves pain management, physical therapy, bracing, and a planned return to activity. Throughout the process, your recovery may seem to move backward at times. But when you follow the four pillars of rehabilitation, you can feel confident that you’re making good progress.

Pain management

Following surgery, pain management is a key component of recovery. Pain management will help you resume activity when it’s safe and recommended. After surgery, you’ll receive painkillers to take at home, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Always follow your surgeon’s directions on when to take painkillers, how much to take, and how to wean off them.

Physical therapy

A physical therapist creates a specialized protocol with exercises and other treatments to help you regain knee function. Quad exercises, which help rebuild needed muscle after surgery, are one type of recovery exercise. Exercises that work your range of motion, knee flexion and extension, and balance are all important for a good physical therapy program, says Dr. Salah. Remember that rehabilitation is not linear. At times, it can be frustrating with good and bad days, but seeing a physical therapist two to three times per week and practicing exercises at home will help you steadily progress.

Bracing and immobilization

After surgery, patients should keep the knee protected with a brace and minimize weight bearing for the first six weeks, says Dr. Grant. Depending on the extent of your injury, you may need to wear a brace or a device called an external fixator, which keeps the leg bones properly aligned via pins that go through your skin to hold external rods in place. As your knee heals, you’ll stop wearing the brace, as advised by your provider.

Gradual return to weight-bearing activities

Along with wearing a knee brace, you’ll receive crutches to protect your knee and be advised to limit weight-bearing activities, says Dr. Salah. Over several weeks, you’ll slowly transition from using two crutches to one, and then none, wearing the brace only. During this time, you’ll also gradually return to normal activities as advised by your provider.

The recovery timeline largely depends on your previous lifestyle and goals. It’s a lengthy process that heavily relies on rehabilitation. For example, if you have a sedentary desk job, you can expect to be walking around within two to three months, he says. If you regularly participate in physical sports, like running, jogging, soccer, football, or volleyball, it may take nine to 12 months until you return to unrestricted activity.

Preventing Future Knee Dislocations

In many instances, such as an unexpected traumatic injury like a car accident, preventing a knee dislocation is not possible. If you dislocated your knee by falling, you can reduce your fall risk by using non-skid mats in showers and installing handrails on both sides of stairs — and using them.

If you’re an athlete, even at a recreational level, discuss with your physical therapist how to maintain muscle strength, mobility, and flexibility. Work with your physical therapist or athletic trainer to learn and practice correct movement patterns. These steps can significantly reduce your risk of re-injury and improve your overall performance.

“After surgery, the ligament that was repaired should be much stronger,” says Dr. Salah. “The best way to prevent a recurrence is gaining strength, balance, and flexibility through strength-building and range-of-motion exercises,” he says.

Long-Term Prognosis After Dislocated Knee Surgery

Knee dislocation is significant and the road to recovery is long. But with the right surgery and rehabilitation plan, you can regain good knee function. Recovery may take up to a year before you return to normal activity levels.

“Be prepared that your knee won’t be ‘normal’ again,” says Dr. Grant. “The goal is for you to be functional in your day-to-day life. We want you to be able to bend your knee, sit down, take stairs, and bend down,” he says, adding that dedication to rehab affects your outcome. If you are an athlete, proper rehabilitation can help you return to your sport.

There are long-term considerations after knee dislocation, including a higher likelihood of developing arthritis. “You may notice occasional knee symptoms, like some aching with changing weather or swelling after a change in activity level,” says Grant.

Working with your provider to properly care for your knee helps ensure an active lifestyle.

Frequently Asked Questions (FAQs)

How long does it take to recover from knee dislocation surgery?

Knee dislocation is an injury that can vary widely, and recovery is gradual. You can return to a sedentary job within two or three months, with full return to previous activity in about nine to 12 months.

Does a dislocated knee need surgery?

Knee dislocation doesn’t automatically require surgery, but most of these injuries do. Whether a nonsurgical or surgical approach is best depends on the extent of injury, ligaments or cartilage involved, blood vessel or nerve damage, and if the knee could be realigned after injury.

What is the recovery time for open knee surgery?

Open knee surgery involves placing a long incision to access the knee. Recovery time varies depending on the reason for surgery and the procedures performed.

Is arthroscopic knee surgery worth it?

Arthroscopic knee surgery is a minimally invasive procedure to repair injured or torn meniscus and ligaments. Recovery is shorter compared to open knee surgery and carries a lower risk of complications. Discuss with your surgeon whether it’s appropriate based on your injury, lifestyle, and treatment goals.

What is knee dislocation surgery called?

Different types exist. Kneecap dislocation surgery is called patellofemoral reconstruction surgery. For true knee dislocation, you may need meniscus repair or ligament reconstruction, depending on the injured tissues.

Can you fix a dislocated knee without surgery?

Initially, doctors attempt to realign the knee joint with a reduction maneuver. While some cases don’t require surgery, most knee dislocations do need surgical repair given the severity of the injury.

Conclusion

If knee dislocation surgery is in your future, taking proactive steps now can help you build a comprehensive recovery plan. Speaking with an orthopedic specialist about surgical and nonsurgical treatment options, as well as post-surgery rehabilitation, is crucial. Connect with a physician at Commons Clinic. Our specialists can guide you through the process and help you make informed decisions about your treatment.

While not all knee dislocations require surgery, most need procedures like meniscus repair or ligament reconstruction to realign the joint. The key to recovery lies in your rehabilitation plan, which should include individualized physical therapy from a professional. With dedication to recovery, you can return to normal mobility in your everyday life.

Sources

StatPearls. Patella Dislocation. July 4, 2023. 

https://www.ncbi.nlm.nih.gov/books/NBK538288

StatPearls. Knee Dislocation. Feb. 27, 2024.

https://www.ncbi.nlm.nih.gov/books/NBK470595

Stanford Medicine. Types of Knee Ligaments. 

https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/knee-ligament-injury/types.html

Penn Medicine. Kneecap Dislocation.

https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/kneecap-dislocation

American Academy of Orthopedic Surgeons (AAOS). Osteotomy of the Knee. May 2022.

https://orthoinfo.aaos.org/en/treatment/osteotomy-of-the-knee

Johns Hopkins Medicine. Bone Grafting. 

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/bone-grafting

Merck Manual. Knee Dislocations. Jan. 2023.

https://www.merckmanuals.com/home/injuries-and-poisoning/dislocations/knee-dislocations

The Open Orthopaedics Journal. Outcomes of Operatively Treated Acute Knee Dislocations. Jan. 19, 2010. https://pmc.ncbi.nlm.nih.gov/articles/PMC2836735/