The Role of Arteriography in Assessing Popliteal Artery Injury in Knee Dislocations

BACKGROUND: This study aimed to review the need for angiography among patients with traumatic knee dislocations, and to evaluate any adverse consequences associated with the clinical decision to pursue or defer angiography. METHODS: A retrospective analysis was performed for 55 patients (57 knees) with traumatic knee dislocation during a 7-year period. The presence or absence of arterial injury was assessed via physical examination (to determine presence of foot pulses and ankle-brachial index > or = 0.80) and, in selected cases, via angiography. RESULTS: At the vascular examination, 32 knees (56%) were found to be normal and 25 (44%) to be abnormal. None of the 32 knees with normal examination results had substantial vascular injuries, as determined by angiography in 13 cases (41%) or by clinical follow-up assessment in 19 cases (59%). All 25 patients with abnormal vascular examination results underwent angiography, with 12 patients (48%) demonstrating vascular injury (7 major and 5 minor injury). Seven patients (6 with major and 1 with minor injury) underwent surgical repair with reverse saphenous vein grafting. CONCLUSIONS: No limb with initial normal vascular examination results was found to have a vascular injury that required treatment. Routine screening angiography may not be necessary for all patients with traumatic knee dislocations.