J Knee Surg 2022; 35(05): 498-501
DOI: 10.1055/s-0042-1743224
Special Focus Section

Review of Extensor Mechanism Injuries in the Dislocated Knee

Munachukwudi Okoye
1   Department of Radiology, University of Missouri, Columbia, Missouri
,
Abigail Wissman
2   Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
,
1   Department of Radiology, University of Missouri, Columbia, Missouri
› Author Affiliations

Abstract

Knee dislocations, aka multiligamentous injuries, are uncommon but devastating injuries often following high-energy trauma. Tears of the major knee stabilizers are well documented; however, injuries of the knee extensor mechanism are less commonly reported. The extensor mechanism is comprised of the patella, patellar tendon, and quadriceps tendons. Magnetic resonance imaging (MRI) is the preferred imaging modality of internal derangements of the knee due to its excellent soft tissue contrast. In this article, we will discuss the normal imaging findings of the extensor mechanism and review abnormalities following knee dislocation.



Publication History

Received: 14 July 2021

Accepted: 23 December 2021

Article published online:
28 February 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Shelbourne KD, Porter DA, Clingman JA, McCarroll JR, Rettig AC. Low-velocity knee dislocation. Orthop Rev 1991; 20 (11) 995-1004
  • 2 O'Malley M, Reardon P, Pareek A, Krych A, Levy BA, Stuart MJ. Extensor mechanism disruption in knee dislocation. J Knee Surg 2016; 29 (04) 293-299
  • 3 Kapur S, Wissman RD, Robertson M, Verma S, Kreeger MC, Oostveen RJ. Acute knee dislocation: review of an elusive entity. Curr Probl Diagn Radiol 2009; 38 (06) 237-250
  • 4 Yu JS, Goodwin D, Salonen D. et al. Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging. Am J Roentgenol 1995; 164 (01) 135-139
  • 5 Kennedy JC. Complete dislocation of the knee joint. J Bone Joint Surg Am 1963; 45: 889-904
  • 6 Goebel CP, Domes C. Classifications in brief: the Schenck classification of knee dislocations. Clin Orthop Relat Res 2020; 478 (06) 1368-1372
  • 7 Helito PVP, Peters B, Helito CP, Van Dyck P. Imaging evaluation of the multiligament injured knee. Ann Joint 2018 3. DOI: 10.21037/aoj.2018.09.03
  • 8 Yablon CM, Pai D, Dong Q, Jacobson JA. Magnetic resonance imaging of the extensor mechanism. Magn Reson Imaging Clin N Am 2014; 22 (04) 601-620
  • 9 Aframian A, Smith TO, Tennent TD, Cobb JP, Hing CB. Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy. Knee Surg Sports Traumatol Arthrosc 2017; 25 (12) 3755-3772
  • 10 Galla M, Lobenhoffer P. Patella fractures [in German]. Chirurg 2005; 76 (10) 987-997 , quiz 998–999
  • 11 Melvin JS, Mehta S. Patellar fractures in adults. J Am Acad Orthop Surg 2011; 19 (04) 198-207
  • 12 Pengas IP, Assiotis A, Khan W, Spalding T. Adult native knee extensor mechanism ruptures. Injury 2016; 47 (10) 2065-2070
  • 13 Wissman RD, Verma S, Kreeger M, Robertson M. Extensor mechanism injuries in tibiofemoral dislocations. J Comput Assist Tomogr 2009; 33 (01) 145-149
  • 14 Lee D, Stinner D, Mir H. Quadriceps and patellar tendon ruptures. J Knee Surg 2013; 26 (05) 301-308
  • 15 Yu JS, Petersilge C, Sartoris DJ, Pathria MN, Resnick D. MR imaging of injuries of the extensor mechanism of the knee. Radiographics 1994; 14 (03) 541-551
  • 16 Zernicke RF, Garhammer J, Jobe FW. Human patellar-tendon rupture. J Bone Joint Surg Am 1977; 59 (02) 179-183
  • 17 Tzurbakis M, Diamantopoulos A, Xenakis T, Georgoulis A. Surgical treatment of multiple knee ligament injuries in 44 patients: 2-8 years follow-up results. Knee Surg Sports Traumatol Arthrosc 2006; 14 (08) 739-749