title: Knee dislocations with vascular injury: outcomes in the Lower Extremity Assessment Project (LEAP) Study.
abstract: OBJECTIVE
  The purpose of this study is to report the clinical and functional results of a cohort of patients with knee dislocations associated with vascular injury.
  
  
  METHODS
  Patients with knee dislocation and associated vascular injury were prospectively assessed for outcome of severe lower extremity trauma during 2 years. The Sickness Impact Profile was used to assess the functional recovery of the patient. Surgeon and therapist assessments documented clinical metrics and treatment, including salvage or amputation, neurologic recovery, knee stability, and knee motion.
  
  
  RESULTS
  Eighteen patients sustained a knee dislocation and an associated popliteal artery injury. Seven patients were found to have an additional vascular injury. All patients underwent repair of the vascular injury. At the time of final follow-up, 14 knees were successfully salvaged and four required amputation (1 below knee amputation, 2 through knee amputation, and 1 above knee amputation). Eighteen patients had at least a popliteal injury and underwent repair of the vascular injury. The patients with a limb-threatening knee dislocation that was successfully reconstructed had Sickness Impact Profile scores of 20.12 at 3 months, 13.18 at 6 months, 12.08 at 1 year, and 7.0 at 2 years after injury.
  
  
  CONCLUSIONS
  Patients who sustain a limb-threatening knee dislocation have a moderate to high level of disability 2 years after injury. Nearly one in five patients who present to a Level I trauma center with a dysvascular limb associated with a knee dislocation will require amputation. Prolonged warm ischemia time was associated with a high rate of amputation. Patients who sustain vascular injuries associated with a knee dislocation need immediate transport to a trauma hospital, rapid assessment and diagnosis at presentation, and revascularization. Patients with these injuries can be effectively treated without angiography before surgery.
authors: Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors: Brendan M
authors: BM
authors: Patterson
authors: Julie
authors: J
authors: Agel
authors: Marc F
authors: MF
authors: Swiontkowski
authors: Ellen J
authors: EJ
authors: Mackenzie
authors: Michael J
authors: MJ
authors: Bosse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology / Q000503:physiopathology; D031221:Knee Dislocation / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D023821:Limb Salvage / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D014481:United States / Q000453:epidemiology