Popliteal Artery Injury Following Knee Dislocation: Anatomy, Diagnosis, Treatment, and Outcomes

Background/Objectives: Popliteal artery injury is a rare but devastating complication of knee dislocations, significantly increasing the risk of limb ischemia, amputation, and poor functional outcomes if not promptly managed. This systematic review primarily evaluates the functional outcomes associated with this injury but also reviews current research on diagnostic modalities and treatment strategies to provide a comprehensive understanding of this severe orthopedic and vascular injury. Methods: A systematic search of PubMed, in accordance with PRISMA Guidelines, identified 144 studies, of which 13 full-text articles were assessed for eligibility after excluding 131 during the title and abstract screening. Six studies were excluded due to missing vascular injury or functional outcome data or being written in a foreign language, leaving seven studies for inclusion. These studies were predominantly retrospective, focusing on knee dislocations with popliteal artery injury and reporting validated functional outcomes such as the Lysholm and International Knee Documentation Committee (IKDC) scores. The data were synthesized narratively due to heterogeneity in the study designs, interventions, and outcome reporting. Results: Patients with vascular injuries consistently demonstrated poorer functional outcomes compared to those without, with mean or median Lysholm and IKDC scores consistently being lower than non-vascular injury patients. Increased BMI, delayed intervention, and multi-ligamentous injury were associated with worse outcomes, highlighting the importance of timely surgical management. Early repair and grafting techniques improved functional recovery, while diagnostic modalities such as Doppler ultrasound and CT angiography showed high sensitivity in detecting vascular injury. Complications included limb ischemia, prolonged rehabilitation, and amputation, often linked to delayed diagnosis. Conclusions: Knee dislocations with popliteal artery injury require rapid diagnosis and early surgical intervention to optimize functional outcomes and reduce complications. Standardized outcome measures and high-quality prospective research are needed to refine management strategies and address patient-specific factors like BMI.