Congenital dislocation of the knee

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Developmental Pediatrics

Background:

• Congenital knee dislocation (CKD) is a rare but significant pediatric orthopedic condition.
• CKD is frequently associated with other congenital anomalies, including breech presentation and clubfoot.
• Understanding the long-term outcomes and optimal treatment strategies for CKD is crucial for pediatric orthopedic care.

Purpose of the Study:

• To review the long-term outcomes of congenital knee dislocations in a pediatric cohort.
• To identify factors influencing treatment success and prognosis in congenital knee dislocation.
• To evaluate the role of specific surgical techniques, such as quadriceps lengthening, in managing associated hip dislocations.

Main Methods:

• Retrospective review of 23 congenital knee dislocations in 17 patients.
• Average follow-up duration of 11 years.
• Analysis of treatment modalities (serial casting, surgical intervention) and associated anomalies.

Main Results:

• A 30% incidence of breech delivery and 41% incidence of clubfoot were observed.
• Serial casting achieved successful reduction in 10 knees (43.5%), while 13 knees (56.5%) required surgical intervention.
• Prognosis was more favorable in unilateral cases and for patients undergoing surgery before 2 years of age.
• Quadriceps lengthening during knee surgery facilitated ipsilateral hip dislocation reduction.

Conclusions:

• Congenital knee dislocation management requires a tailored approach based on case complexity and patient age.
• Early surgical intervention, particularly before age two, improves outcomes for congenital knee dislocation.
• Associated procedures like quadriceps lengthening are vital for addressing complex presentations involving hip instability.