This injury is often the result of very severe trauma, although can sometimes occur in bariatric patients with otherwise relatively minor falls. When a patient gives a history that the “knee came out of place,” the injury is usually not a knee dislocation but rather a patella dislocation or anterior cruciate ligament tear. True dislocation of the knee is a very serious injury notable for a high risk of vascular injury to the pop­liteal vessels. The popliteal artery is xed anatomi­cally at the level of the proximal tibia by the interosseous membrane and, therefore, is at great risk when the knee dislocates. Careful physical exam should be performed including a full vascular exam with evaluation of pulses and ABIs. Arteriography can be performed following immedi­ate closed reduction of the dislocation if vascular compromise is suspected. The results of angiogra­phy will then determine whether consultation of the vascular surgery team and arterial repair is neces­sary. If gross instability is present following this injury, an external xator bridging the knee may be necessary until denitive ligament repair can be performed. Multiple ligament injuries are the norm after knee dislocations. Ligamentous repair/recon­struction is usually necessary after early emergent reduction, external xation, and vascular manage­ment have been accomplished.