Knee > Knee Dislocation > Treatments

   Closed Reduction, Immobilization, and Bracing

Procedure

Your physician helps relax your thigh muscles and calm you down. You are usually awake and given narcotic painkillers when your knee is put back in place. You may also be given muscle relaxants. With the appropriate combination of pulling and rotating, your knee essentially pops back into place. The reduction should only be done by a highly trained physician, as the complications of a knee dislocation can be serious.

Most patients have their knee put back in place in the hospital's emergency room and then are fitted with a brace or immobilizer. Your knee will be elevated, and an ice pack may be used to reduce pain and swelling. You generally will feel sharp pain and physicians may prescribe narcotic painkillers. Pain medication may be administered orally or through an IV (intravenous) line. Physicians generally recommend that you use crutches or a cane to help you walk for up to six to eight weeks. You may be uneasy on the crutches at first and you may be on prescription-strength painkillers. You should have someone available to help you leave the hospital and take you home.

After a knee dislocation, you will need to take steps to reduce the pain and inflammation in the knee. Rest, icing, elevation, and painkillers such as aspirin or ibuprofen can ease pain and swelling, and immobilizing the knee will keep it stabilized. Your experience at home will differ depending on whether your knee is in a cast or a removable brace. Here is what you can expect and how you can cope with a cast immobilizing your leg:

   Monitor swelling for the first 48 hours while wearing your cast. If your swelling decreases dramatically, the cast may become too loose, and not support your leg. If swelling increases, circulation can be dangerously cut off. In both cases, you should contact your physician.

   Keep your cast dry. Wrap it in a plastic shower bag whenever you may come in contact with water. Ask your physician about the best place to buy plastic shower bags in your area.

   Like most knee injuries, treat with R.I.C.E. (Rest, Ice, Compression, Elevation). Ask your physician whether it is safe to put weight on your injured leg. Wrap ice into a well-sealed plastic bag and drape around the cast at knee level for 20 to 30 minutes, two or three times a day. Elevate the injured leg above heart level to help blood drain towards your body. It often helps to sleep with pillows under your ankles.

   Move your toes as much as possible to help circulate blood.

   Call your physician if you develop a rash or irritated skin around your cast.

   Call your physician if you notice any abnormal wear or discomfort. In general, do not try to simply tolerate discomfort that does not go away within a few days.

   To avoid complications, only your doctor should remove the cast with a special vibrating cast saw.

If your physician prescribes a brace, rehab can usually begin within a few days of the dislocation. You should immobilize your knee by wearing the brace as prescribed by your physician. Depending on the severity of the knee dislocation and the demands of your job, you may need to be out of work for six weeks or more.

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If your knee is in a cast, you will not begin physical therapy until it is removed. Recreational and sports activities may be delayed up to a year or more depending on the injury. Patients should begin seeing a physical therapist a few days after surgery. Your physician and physical therapist can help design a custom rehabilitation program that will start slowly with motion exercises. Your program will most likely consist of some exercises done under the supervision of the therapist and some at home on your own. Strengthening exercises require dedication because it may take months for a patient to see results. Once the muscles of your injured leg are about as strong as the uninjured leg, the focus of rehab turns to increasing your coordination. At this point, physical therapy tends to become activity oriented as you regain the ability to perform complicated movements.

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   Knee strengthening exercises: Knee dislocation

Strength, endurance, flexibility, and generalized fitness are the keys to avoiding re-injury after a knee dislocation. Your main prevention goal should be to strengthen your quadriceps and hamstring muscles so they are stronger than before the dislocation. Making the strengthening exercises you learned in rehab part of your regular conditioning routine is the best way to prevent future knee injuries. A repeat dislocation is rare, but your knee may be more prone to other injuries. Depending on the severity of your dislocation and the success of your rehab program, your physician may recommend that you avoid contact sports or risky, high-speed activities. You may be prescribed a brace to wear during activities. Your physician can recommend the best types of protective gear for your knees.

Some knee dislocations can be treated without surgery by popping the joint back into place (closed reduction) and then immobilizing the knee for a period of time. Surgery is often required to repair structures injured at the time of the dislocation, but there may be situations in which your physician recomments non-operative treatment.