Neglected Posterior Knee Dislocation: An Unusual Case Report

Abstract

Chronic dislocation of the knee is a rare condition due to a diagnostic mistake during emergency assessment. Usually, dislocation obliges the surgeon to carry out a broad assessment, with vascular and neurological examination, and a thorough assessment of joint injuries. The immediate and stable closed reduction can resolve neurovascular compression. The most serious late sequela is joint instability with impairment of ambulation and patient's autonomy. Treatment of neglected knee dislocation is surgical, that is, arthrodesis or arthroplasty, the latter representing the treatment of choice. The case described herein appears unique because of the clinical and radiographic features. Interestingly, over the years, the neurovascular bundle has inadvertently adapted to the posterior femur displacement without secondary damage.

Two years neglected knee dislocation: An unusual case report

“…Knee dislocations are rare injuries that can be underestimated during the emergency assessment. Dislocation, or subluxation of the knee, can be misdiagnosed at the time of the trauma, particularly in the absence of neurovascular injuries, which usually lead to surgical treatment [6] , [7] , or the presence of severe trauma that disguises dislocation as the case for our patient.…”

“…Most acute knee dislocations are either reduced spontaneously at the accident site or reduced in the emergency department [4] . Neglected knee dislocations are not commonly seen, as the severity of the injury always leads to an early diagnosis [7] .…”

“…Arthrodesis is instead necessary in the presence of severe instability, paralysis, neuropathy, infections, and damage to the extensor mechanism. Although arthrodesis can cause persistent knee pain, lower back pain and limitations in resuming working activities [7] . There are a few reports on arthroplasty for chronic posterior knee dislocation.…”

Delayed treatment of neglected open knee dislocation; case report

“…Knee dislocation and subluxation is a rare pathologic condition that can be accurately detected and treated during an emergency assessment [6] , [7] . Most acute knee dislocations are either spontaneously reduced at the scene of the accident or reduced by clinicians in the emergency department.…”

Arthroscopically-assisted knee joint arthrodesis by custom-made intramedullary locking nail with simultaneous femur deformity correction (case report)

“…Анализ современных публикаций по данному вопросу подтверждает, что основными показаниями для артродезирования коленного сустава являются: последствия глубокой инфекции после эндопротезирования, когда реэндопротезирование невозможно или будет сочетаться с крайне высоким риском рецидива инфекции, или перенесенного септического гонита [11,[20][21][22], посттравматические дефекты костей, формирующих коленный сустав, наличие патологических рубцов, несостоятельность связочного аппарата коленного сустава после длительно существующего вывиха или подвывиха голени, при которой имплантация даже связанного эндопротеза может сочетаться с высоким риском разобщения его компонентов [23].…”