Management of Chronic Posterior Tibial Subluxation

  • Steven C. Chudik
  • Peter T. Simonian
  • Thomas L. Wickiewicz


Chronic fixed posterior tibial subluxation in the multiple ligament injured knee, although extremely rare, is a difficult problem that requires complex management. There are two opposing goals after catastrophic ligamentous knee injury: stability and range of motion. Achieving both of these goals can be very difficult.1–8 Multiple ligamentous reconstructions are currently the recommended method of dealing with acute unstable knee injuries.1–4,9–11 Despite modern techniques, recurrent knee laxity or stiffness can be prob-lematic.l–3,5–8,11,12 These problems are amplified in the case of a chronic posterior tibial subluxation.


Anterior Cruciate Ligament Total Knee Arthroplasty Knee Flexion Posterior Cruciate Ligament Medial Collateral Ligament 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Almekinders LC, Logan TC. Results following treatment of traumatic dislocations of the knee joint. Clin Orthop 1992; 284: 203–207.PubMedGoogle Scholar
  2. 2.
    Almekinders LC, Dedmond BT. Outcomes of the operatively treated knee dislocation. Clin Sports Med 2000; 19: 503–518.PubMedCrossRefGoogle Scholar
  3. 3.
    Dedmond BT, Almekinders LC. Operative versus nonoperative treatment of knee dislocations. Am J Knee Surg 2001; 14 (1): 33–38.PubMedGoogle Scholar
  4. 4.
    Fanelli GC. Treatment of combined anterior cruciate ligament-posterior cruciate ligament-lateral side injuries of the knee. Clin Sports Med 2000; 19: 493503.Google Scholar
  5. 5.
    Frassica FJ, Sim FH, Staeheli JW, Pairolero PC. Dislocation of the knee. Clin Orthop 1991; 263: 200–205.PubMedGoogle Scholar
  6. 6.
    Roman PD, Hopson CN, Zenni EJ. Traumatic dislocation of the knee: a report of 30 cases and literature review. Orthop Rev 1987; 16: 917–924.PubMedGoogle Scholar
  7. 7.
    Shields L, Mital M, Cave EF. Complete dislocation of the knee: experience at the Massachusetts General Hospital. J Trauma 1969; 9: 192–215.PubMedCrossRefGoogle Scholar
  8. 8.
    Thomsen PB, Rud B, Jensen UH. Stability and motion after traumatic dislocation of the knee. Acta Orthop Scand 1984; 55: 278–283.PubMedCrossRefGoogle Scholar
  9. 9.
    Myers MH, Moore TM, Harvey JR Traumatic dislocation of the knee joint. J Bone Joint Surg Am 1975; 57: 430–433.Google Scholar
  10. 10.
    Sisto DJ, Warren RE Complete knee dislocation. A follow-up study of operative treatment. Clin Orthop 1985; 198: 94–101.PubMedGoogle Scholar
  11. 11.
    Stayner LR, Coen MJ. Historic perspectives of treatment algorithms in knee dislocation. Clin Sports Med 2000; 19: 399–413.PubMedCrossRefGoogle Scholar
  12. 12.
    Montgomery JB. Dislocation of the knee. Orthop Clin North Am 1987; 18: 149–156.PubMedGoogle Scholar
  13. 13.
    Henshaw RM, Shapiro MS, Oppenheim WL. Delayed reduction of traumatic knee dislocation. Clin Orthop 1996; 330: 152–156.PubMedCrossRefGoogle Scholar
  14. 14.
    Petrie RS, Trousdale RT, Cabanela ME. Total knee arthroplasty for chronic posterior knee dislocation. J Arthroplasty 2000; 15: 380–386.PubMedCrossRefGoogle Scholar
  15. 15.
    Richter M, Lobenhoffer P. Chronic posterior knee dislocation: treatment with arthrolysis, posterior cruciate ligament reconstruction and external fixation device. Injury 1998; 29: 546–549.PubMedCrossRefGoogle Scholar
  16. 16.
    Simonian PT, Wickiewicz TL, Hotchkiss RN, et al. Chronic knee dislocation: reduction, reconstruction, and application of a skeletally fixed knee hinge. Am J Sports Med 1998; 26: 1–5.CrossRefGoogle Scholar
  17. 17.
    Simonian PT, Shafer BL, Wickiewicz TL. Management of chronic posterior tibial subluxation in the multiligament-injured knee. Sports Med Arthrosc Rev 2001; 9: 239–246.CrossRefGoogle Scholar
  18. 18.
    Laasonsen EM, Kivioja A. Delayed diagnosis of extremity injuries in patients with multiple injuries. J Trauma 1991; 31: 257–260.Google Scholar
  19. 19.
    Montgomery TJ, Savoie FH, White JL, et al. Orthopedic management of knee dislocations: comparison of surgical reconstruction and immobilization. Am Knee Surg 1995; 8: 97–103.Google Scholar
  20. 20.
    Simonian PT, Sussman PS, Wickiewicz TL, et al. The skeletally fixed knee hinge for the grossly unstable knee. Am J Knee Surg 1998; 11: 181–187.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2004

Authors and Affiliations

  • Steven C. Chudik
  • Peter T. Simonian
  • Thomas L. Wickiewicz

There are no affiliations available

Personalised recommendations