Congenital knee deformity: rare case report and unexpected finding in the delivery room

Congenital knee dislocation (CKD), or genu recurvatum, is an uncommon congenital deformity marked by knee hyperextension and restricted flexion. It may occur either as an isolated finding or in association with other conditions. CKD can be diagnosed prenatally or postnatally. Most of the cases are treated during infancy by manipulation and serial casting or splinting without surgical intervention. This case report aims to enhance the understanding of this condition and its associations, improving the process of early diagnosis and management to prevent long-term functional impairment.

We report a case of a full-term female newborn with bilateral passive fixed hyperextension of the knees, limited flexion, and a full range of motion. She was born via lower segment caesarean section (LSCS) to a 28-year-old G3P1A1 (gravida 3, para 1, abortus 1) Emirati patient. The pregnancy was complicated by iron deficiency anemia, frequent micturition, vulvovaginitis, and gestational diabetes mellitus. The patient underwent knee reduction-manipulation and received serial casting and repeated radiographic evaluation for improvement. After 1 year of physiotherapy and serial casting followed by splinting, the patient exhibited an excellent prognosis and is walking normally with no pain or progressive deformity; however, a small degree of hyperextension remains.

Early recognition is crucial to enable prompt treatment and improve the likelihood of a favorable outcome. Management should be tailored to the condition of the joint and any associated abnormalities.