[Ultrasound imaging of congenital knee joint dislocation. Value in diagnosis and therapy]

Congenital dislocation of the knee is a uncommon malformation. Frequently there is an association with other congenital deformities including congenital dislocation of the hip. The classification of Leveuf and Pais into three separate groups (Type A, Type B, Type C) is now widely accepted. Between October 1989 and April 1995 we evaluated ten children (five girls and five boys) with twelve dislocated knees. Clinical, radiographic and different ultrasonography examinations were carried out on both knees. The sonographic classification showed Type A in 3, Type B in 5 and Type C in 4 cases. The sonographic examination revealed the essential anatomic structures and their pathomorphology. The anterior and the posterior cruciate ligament could be demonstrated in the majority of the cases. Three dislocated knees showed an obliteration of the recessus suprapatellaris and fibrotic changes in the m. quadriceps. These cases required operative treatment. With conservative treatment we achieved a satisfactory result in eight children with nine disease knees. There was a good functional result with an average flexion of 106 degrees. Early conservative treatment recommend as the therapy of choice. Ultrasonography imaging offers the possibility of reliable differentiation into one of the three groups of the classification of Leveuf and Pais. Radiographic documentation during the therapy has become the exception. Ultrasonography imaging helped substantially in the decision making and the timing of operative treatment.