Abstract
Though a relatively rare orthopedic injury, knee dislocation in the morbidly obese
population has been increasingly reported in the literature. These injuries are often
referred to as “ultralow-velocity knee dislocations” since they commonly occur after
a seemingly trivial injury, such as a ground level fall. As a result, these injuries
are often underappreciated and initially misdiagnosed. Even though these injuries
are low-velocity, they should still be regarded as a high energy injury because of
the large amount of mass contributing to the dislocating force. Knee dislocations
in the morbidly obese are associated with a particularly high rate of neurovascular
injury. A timely and accurate diagnosis is crucial to avoid serious limb-threatening
complications, including the need for amputation. Therefore, evaluating physicians
should maintain a high suspicion for a knee dislocation in any morbidly obese patient
who presents with knee pain following a seemingly innocuous injury. Management of
these injuries is controversial. Associated vascular injuries must be identified promptly
and appropriately managed by a vascular surgery team. There is no consensus on the
ideal orthopedic treatment of knee dislocations in the morbidly obese patient. Operative
treatment can be fraught with complications, including a higher rate of neurovascular
injury, increased surgical complications, and poor subjective patient outcome scores
compared with nonobese patients sustaining a high-velocity knee dislocation. It is
paramount that treating physicians are familiar with the unique challenges of treating
knee dislocations in the morbidly obese patient when discussing risks and benefits
of treatment options. This article presents a review of the existing literature on
knee dislocations in the morbidly obese population, including diagnosis, management,
and outcomes.
Keywords
knee dislocation - morbidly obese - ligament reconstruction
