Management of Congenital Dislocation of the Knee

Abstract

Congenital knee dislocation is a rare disorder and the published literature largely consists of small case series. Congenital knee dislocation represents a broad spectrum of severity from hyperextension to frank dislocation. It can be isolated or be present in syndromic infants with concomitant joint disorders such as clubfoot or developmental dysplasia of the hip. Hyperextended knees can be reduced with serial casting alone in the neonatal period and do not require further treatment. Surgical treatment of the congenital knee dislocation results in satisfactory outcomes in the majority of reported cases, although outcomes are highly dependent on the degree of concomitant joint involvement. Treatment decisions are often based on radiographic findings and passive range of motion of the knee. Described procedures include percutaneous or mini-open quadriceps tenotomy, VY quadricepsplasty, and femoral shortening. The current review summarizes the most up-to-date literature on the surgical management of congenital knee dislocation.

Recalcitrant congenital knee dislocation: a case report of successful serial casting in a dysmorphic infant

“…Clinicians should be aware of the possibility of injury to the physeal plate caused by vigorous reduction maneuvers. 1 Extended duration of serial castings may expose the child to the risk of blisters or pressure ulcers as well as limb-threatening compartment syndrome. 10 Inadequate cast length and poor technique in cast application may result in loss of reduction or cast displacement.…”

“…Nevertheless, the conservative management of CKD is not without its complications. Clinicians should be aware of the possibility of injury to the physeal plate caused by vigorous reduction maneuvers 1. Extended duration of serial castings may expose the child to the risk of blisters or pressure ulcers as well as limb-threatening compartment syndrome 10.…”

“…It covers a wide spectrum of severity ranging from subluxation to dislocation. This is a rare condition with an incidence of one in 100,000 livebirths with higher frequency reported in the female population 1. It may occur in isolation but occurs more commonly in combination with other musculoskeletal anomalies such as developmental dysplasia of hip (DDH) and congenital talipes equinovarus (CTEV).…”

“…This is a rare condition with an incidence of one in 100,000 livebirths with higher frequency reported in the female population. 1 It may occur in isolation but occurs more commonly in combination with other musculoskeletal anomalies such as developmental dysplasia of hip (DDH) and congenital talipes equinovarus (CTEV). Further investigation is always advocated because of possible association with conditions like arthrogryposis multiplex congenita, myelomeningocele, Marfan, Ehler-Danlos, and Larsen syndromes.…”