Dislocating the knee takes a lot of force. It’s the largest joint in the body and is held tightly together by ligaments. When events like a car crash tear these connections apart, UT Southwestern Medical Center’s Assistant Professor of Orthopaedic Surgery Ashoke Sathy, M.D., is ready. A trauma surgeon who’s highly trained in reconstructing the dislocated knee, Dr. Sathy says many patients can return to their pre-injury status with treatment.
We do a good job here of managing complex periarticular injuries like pilon fractures, calcaneus fractures, and polytrauma."
Fixing a dislocated knee is generally a multi-step procedure. First, the surgeon uses open surgical techniques to fix the rear part of the knee (the posterolateral and posteromedial corners, or PLC and PMC). After that come repairs to the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL); these are done in large part with the minimally invasive arthroscope.
Once the anesthesia wears off, it’s the patient’s turn. “There’s a pretty elaborate postop rehab protocol that extends for six months after the surgeries, so patients need to really be diligent with their physical therapy,” says Dr. Sathy. Immediately following surgery, he adds, it’s crucial to begin range-of-motion exercises to avoid getting stiff.
“Part of that is up to us – we’ve got to reconstruct it with stable fixation to allow for early range of motion. That’s where our reconstruction techniques come in,” Dr. Sathy says. “A lot of times we’ll supplement it with a hinged external fixator (brace), which allows them to move their knee and still protect the repair.”
Maintaining range of motion is so crucial that patients may need a follow-up operation to break up tight scar tissue.
Although he meets most of his patients after they’ve come into an ER with a knee or bone injury, Dr. Sathy also sees non-emergency cases through his private practice, many with old bone injuries that haven’t healed properly – malunions and nonunions. With surgery, these can be repaired, leaving the patient better able to use the limb and with less pain.
- Orthopedic trauma
- High energy trauma
- Anterior cruciate ligament (ACL) repair
- Knee dislocation
- Multiligamentous knee injuries
- Acetabular fracture
- Ankle syndesmosis injury fixation
- Calcaneus fracture
- Femur fracture
- Humerus fracture
- Infix for pelvic fracture
- Pelvic fracture
- Percutaneous fracture repair
- Periarticular fracture
- pilon fracture
- Posterior cruciate ligament (PCL) repair
- Posterolateral corner (PLC)
- Posteromedial corner (PMC)
- Gastrocnemius flaps
- Rotational flaps
- Soleus flaps
- Tibial fracture