Congenital dislocation of the knee.

Area of Science:

• Orthopaedics
• Paediatric Medicine
• Congenital Abnormalities

Background:

• Congenital dislocations of the knee (CDK) are exceptionally rare, occurring significantly less frequently than congenital dislocations of the hip (CDH).
• A multicentric study identified 56 cases of CDK in 46 infants, often associated with other malformations and consistent muscular abnormalities at the knee.
• Leveuf's classification identified grade 3 (complete dislocation) as the most prevalent form of CDK.

Purpose of the Study:

• To analyze the incidence, associated conditions, and treatment outcomes of congenital dislocations of the knee.
• To compare the efficacy of conservative versus surgical management strategies for CDK.

Main Methods:

• Retrospective analysis of 56 congenital dislocation of the knee cases from a European Paediatric Orthopaedic Society multicentric study.
• Review of treatment approaches, including conservative methods (physiotherapy, rigid splinting) and surgical interventions focusing on the extensor apparatus.
• Evaluation of treatment outcomes based on knee flexion range and knee stability.

Main Results:

• Conservative treatment was applied to 24 patients with CDK.
• Surgical interventions involved progressive release and lengthening of the quadriceps tendon in all operated cases.
• All treatment modalities achieved a knee flexion range of 120 degrees; however, conservative treatment demonstrated superior outcomes with only two cases of instability.

Conclusions:

• Congenital dislocations of the knee require careful management, with conservative approaches showing promising results.
• Early physiotherapy and splinting may be effective, while surgical intervention necessitates addressing extensor apparatus abnormalities.
• Further research into optimal treatment strategies for CDK is warranted to improve patient outcomes and minimize instability.