Nick Chubb had a gruesome injury to his knee during the Monday Night Football game against the Steelers.  His injury is a knee dislocation which can be a devastating injury for a professional football player.  This article will describe what a knee dislocation is and what the outlook might be for his return to play.

A knee dislocation is a severe and potentially life-altering injury that occurs when the bones that make up the knee joint are completely displaced from their normal positions. This often involves the femur (thigh bone), tibia (shin bone), and patella (kneecap) being forced out of alignment. Knee dislocations are typically the result of high-energy trauma, such as a car accident or a sports injury, and they can cause extensive damage to the ligaments, blood vessels, nerves, and other structures in and around the knee. Here are some of the associated injuries and complications that can occur with a knee dislocation:

1. 1. Ligament Injuries:
   – Anterior Cruciate Ligament (ACL) Tear: The ACL is often damaged or torn in knee dislocations.
   – Posterior Cruciate Ligament (PCL) Tear: The PCL can also be injured in knee dislocations.
2. Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL) Injuries: The MCL and LCL, which provide stability to the sides of the knee, may be stretched, partially torn, or completely torn.
3. Blood Vessel Injury: Knee dislocations can cause damage to blood vessels, such as the popliteal artery and vein, which supply blood to the lower leg. A vascular injury can lead to limb-threatening ischemia (lack of blood flow) or even amputation if not promptly treated.
4. Nerve Damage: The nerves around the knee can be stretched or injured during a dislocation, leading to numbness, weakness, or loss of function in the lower leg and foot.
5. Fractures: Fractures of the femur, tibia, or patella may accompany knee dislocations.
6. Meniscus Tears: The meniscus, a cartilage structure in the knee joint, may be torn due to the traumatic displacement of the bones.
7. Articular Cartilage Damage: The articular cartilage covering the ends of the bones in the knee joint can be damaged, which may lead to long-term joint problems like arthritis.
8. Compartment Syndrome: Swelling and increased pressure in the compartments of the leg can occur, potentially causing further tissue damage.

Knee dislocations are considered medical emergencies, and immediate medical attention is critical. The treatment typically involves reducing the dislocated knee joint (putting it back in place) as soon as possible, often in an operating room under anesthesia. After reduction, surgical repair of the injured ligaments and other structures may be necessary.

The report on Nick Chubb was that he would only need repair of his MCL (and his ACL is only partially torn) and he might return in 6-8 months.  This seems optimistic. There is a published study in 2018 in Sports Health looking at multiligament knee injuries in the NFL and their return to play (RTP) statistics.  A total of 50 NFL athletes with multiligament knee injuries were included in the study. The overall return to play rate was 64.0%, though this varies depending on the ligaments torn and which ones needed to be reconstructed or repaired.  Athletes with ACL/MCL tears had an RTP rate of 70.8%, whereas athletes with ACL and posterior collateral ligament/lateral collateral ligament (PCL/LCL) tears had an RTP rate of 55.6%. Even more stark results are that while athletes with ACL/MCL injuries were more likely to return to prior performance level (43.5%) those with ACL and PCL/LCL injuries returned at a very low rate (18.5%).

At Total Orthopedics and Sports Medicine we have orthopedic experts in diagnosing and treating complex cases such as these helping to aid in return to function and sport.