Management of Chronic Posterior Tibial Subluxation in the Multiligament-Injured Knee:

A chronic knee dislocation, although extremely rare, is a difficult problem that requires complex management. Achieving the two opposing goals of obtaining stability and range of motion can be difficult. Despite modem techniques with multiple ligamentous reconstructions using allograft tissues, recur-rent knee laxity or stiffness can be problematic. To reduce the chronically dislocated knee, complete releases of scar tissue and capsule are required, placing increased stresses on the reconstruction. In an attempt to decrease the stress on the newly reconstructed ligaments and still allow knee motion, a skeletally fixed hinge system can be used. This provides a form of protection for the newly reconstructed ligaments, which still allows a functional range of motion. By using this method of hinge fixation it is possible to obtain a stable painless knee while maintaining a functional range of motion with allograft ligament reconstruction in the chronically dislocated knee.