Congenital dislocation of the knee at birth – Part 2: Impact of a new classification on treatment strategies, results and prognostic factors

Rampal, Virginie; Mehrafshan, M.; Ramanoudjame, M.; Seringe, R.; Glorion, Christophe; Wicart, Philippe

doi:10.1016/j.otsr.2016.04.009

Cited by 29 publications

(29 citation statements)

References 14 publications

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“…Consequently, it is important to consider that the patient's condition could also be explained by an isolated congenital dislocation of the knee, or by an AMC-associated dislocation. (16)(17)(18) Likewise, the patient presented with some clinical features compatible with the alternative diagnosis of congenital knee dislocation, such as joint instability, reduction of dislocation with snap or piston, muscle retraction (knee quadriceps, hip adductors), restricted range of motion (hip abduction) and presence of skin folds or grooves, (18) which were more noticeable after achieving complete improvement ( Figure 3).…”

Section: Discussionmentioning

confidence: 91%

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Congenital hyperextension deformity of the knees due to arthrogryposis multiplex congenita? Case report

et al. 2020

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Introduction: Arthrogryposis multiplex congenita is a disorder characterized by non-progressive joint contractures. It has an estimated prevalence of 1 in every 3 000-5 000 live births, with the same male-to-female ratio.Case presentation: This is the case of a male newborn with adequate prenatal care checkup appointments, who presented with a congenital deformity of the lower limbs. On physical examination, he had hyperextension of the knees (passive flexion of 20° in the left leg and 30° in the right leg), and painful active movement. On admission, peripheral pulses had good intensity, and adequate distal perfusion was found. Barlow and Ortolani maneuvers were negative, and no midline lesions were observed in the spine. The patient was diagnosed with arthrogryposis multiplex congenita and received multidisciplinary treatment to avoid early morbidity and mortality.Conclusion: To attain satisfactory clinical development in patients with arthrogryposis, it is essential to have a high level of antenatal suspicion, as well as appropriate prenatal checkups. All this allows for proper management, minimizing diagnostic errors, avoiding unnecessary procedures, and performing effective and timely treatment with outstanding results.

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Section: Discussionmentioning

confidence: 91%

“…(19) The treatment for AMC and congenital knee dislocation is the same, and the recommendations for physical therapy described above should be maintained for 4-8 weeks; depending on the case, a splint and even surgery may be indicated if therapy fails. (16)…”

Section: Discussionmentioning

confidence: 99%

Congenital hyperextension deformity of the knees due to arthrogryposis multiplex congenita? Case report

et al. 2020

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“…Во всех указанных системах оценивается объем движе-ний и стабильность коленных суставов. Неко-торые авторы добавляют в шкалу оценки боль, удовлетворенность результатом, необходимость использования ортопедических приспособлений, а также быструю утомляемость [4,5,13,20,22,23,25].…”

Section: Discussionunclassified

“…Ряд авторов предлагает начинать консервативное ле-чение с момента рождения, некоторые рекомен-дуют наблюдение в течение первого месяца, когда возможно спонтанное вправление ВПВГ [20][21][22][23][24].…”

Section: стадии возникновения врожденного переднего вывиха голениunclassified

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Congenital dislocation of the knee: prenatal diagnostics and treatment at an early age

Rumyantsev

Юрьевич²,

Kruglov

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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3 Санкт-Петербургское ГКУЗ «Диагностический центр (медико-генетический)» Актуальность. Врожденный передний вывих голени (ВПВГ) -это редкое заболевание опорно-двигательной системы с частотой встречаемости 1 на 100 000 живых новорожденных. Своевременная пренатальная диагно-стика и лечение, начатое в первые дни жизни, позволяют избежать инвалидизации ребенка. Цель исследования: изучить возможности пренатальной ультразвуковой диагностики и оценить эффектив-ность ранней ортопедической коррекции с применением консервативных методов лечения. Материалы и методы. За период с января 1988 по февраль 2016 г. были пролечены 37 новорожденных (50 нижних конечностей) с ВПВГ. Первичная оценка пораженных конечностей осуществлялась сразу после рождения. Для определения тяжести вывиха использовались классификации Seringe и Tarek. Всем пациентам проводилось консервативное лечение. Возраст детей в момент начала лечения составил от 2 часов до 5 дней. Были использованы различные методики: этапные гипсовые повязки (10 нижних конечностей), коррекция на шине Розена (8 нижних конечностей); с 2003 г.применялся единый протокол лечения, разработанный авторами исследования. Результаты. Пренатальный УЗ-скрининг позволил выявить ВПВГ до рождения ребенка в 21 % случаев. Отда-ленные результаты (катамнез от 3 до 28 лет) оценивались по шкале Seringe и были отличными в 60 % случаев, хорошими -в 32 % и удовлетворительными -в 8 % случаев. Плохих результатов не было. Все дети, вклю-ченные в исследование, начали самостоятельно ходить в возрасте 9-18 месяцев. Заключение. Пренатальная УЗИ-диагностика позволяет выявить ВПВГ. Лечение новорожденных, начатое в первые часы жизни по протоколу, разработанному авторами, позволяет в короткие сроки, без длительных этапных гипсовых повязок вправить вывих голени. Отдаленные результаты демонстрируют эффективность предложенной методики.Ключевые слова: врожденный передний вывих голени, пренатальная диагностика.

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Prenatal diagnosis and postnatal outcome of fetal congenital knee dislocation: systematic review of literature

Cavoretto,

Castoldi,

Corbella

et al. 2023

Ultrasound in Obstet & Gyne

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ObjectivesCongenital Knee Dislocation (CKD) or Genu Recurvatum is a rare condition affecting 1 over 100,000 newborns, characterized by anterior hyperextension of the knee joint, increased transverse skin folds over the anterior surface of the knee and prominence of femoral condyles into the popliteal fossa. Prenatal diagnosis is poorly described in the literature and challenging, especially when it appears isolated and not in the context of polymalformative or syndromic patterns. The purpose of this study is to provide a comprehensive review of the available literature on prenatal diagnosis and postnatal outcome of this rare condition, to summarize the current evidence on this topic.MethodsWe performed a systematic review of the literature searching for prenatal diagnosis of CKD in all major internet‐based medical databases. A predefined combination of specific key words was used, focusing on intrauterine manifestations, diagnostic methods, prenatal behavior, postnatal treatment and neonatal outcome as well as long‐term outcome on ambulation, motion and joint stability. Study quality was assessed by means of National Institute of Health tool for the quality assessment of Case Series Studies. A summary of results was carried out providing proportions and rates of diagnostic and prognostic features associated with this rare condition.ResultsTwenty cases were retrieved for analysis including nineteen collected from the systematic review and one unpublished case from our experience. Median gestational age at prenatal diagnosis was 22 weeks (range 14‐38 weeks), generally by US. Bilaterality was observed in 11/20 (55%), the condition was isolated in 7/20 cases (35%) and associated to other anomalies in 13/20 cases (65%). An association was observed with oligohydramnios (20%) and invasive procedures were performed in 11 cases (55 %). Genetic studies were normal in all isolated cases and few genetic syndromes were present in 10 of the 13 (77%) non‐isolated cases for which information was available (Larsen, Noonan, Grebe, Desbuquois and Escobar syndromes). There were 7 terminations of pregnancy, of which 6 with associated anomalies and one isolated, 11 livebirths, one intrauterine death and one neonatal death. All fetal or neonatal demises were in fetuses with associated anomalies or abnormal genetics. Postnatal treatment was essentially conservative with only two reports (18% of the 11 liveborn neonates) of surgical interventions, all in cases with associated anomalies. The postnatal follow up was in most of the cases up to the first year and the motor outlook appears normal.ConclusionsCKD is a rare fetal anomaly with a prenatal diagnosis achievable from the early second trimester for which favorable outcome can be predicted when no associated anomalies are present. Prenatal diagnosis should include detailed US assessment and amniocentesis for extensive genetic studies, particularly in non‐isolated cases. Postnatal early treatment achieves success in most cases without surgical intervention and leads to normal motor outlook.This article is protected by copyright. All rights reserved.

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Congenital dislocation of the knee at birth – Part 2: Impact of a new classification on treatment strategies, results and prognostic factors

Abstract: IV, single-center retrospective series.

Cited by 29 publications

References 14 publications

Congenital hyperextension deformity of the knees due to arthrogryposis multiplex congenita? Case report

Congenital hyperextension deformity of the knees due to arthrogryposis multiplex congenita? Case report

Congenital dislocation of the knee: prenatal diagnostics and treatment at an early age

Prenatal diagnosis and postnatal outcome of fetal congenital knee dislocation: systematic review of literature

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