Congenital knee dislocation. Therapeutic protocol and long-term functional results

Marín, J. Salvador; Gorozarri, C. Miranda; Egea-Gámez, Rosa M.; Hernandez, J.; Álvarez, Sergio Martínez; Quevedo, Á. Palazón

doi:10.1016/j.recote.2021.02.005

Cited by 4 publications

(4 citation statements)

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“…CDK is a rare condition that typically exhibits a favorable prognosis in isolated cases but presents a generally poor prognosis when accompanied by multiple deformities [ 18 ]. However, a retrospective study involving 9 patients with at least 9 years of follow-up ,it was demonstrated that timely diagnosis and prompt initiation of suitable conservative treatment resulted in favorable long-term functional outcomes in the affected limbs, with few occurrences of complications and recurrence [ 26 ]. A retrospective study was conducted on 24 patients who received surgical treatment more than six months after birth.…”

Section: Discussionmentioning

confidence: 99%

Congenital dislocation of the knee complicated with bilateral hip dislocation: a case report and literature review

Qi,

Jie,

Wang

et al. 2024

BMC Musculoskelet Disord

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Background Congenital dislocation of the knee is characterised by excessive knee extension or dislocation and anterior subluxation of the proximal tibia, and this disease can occur independently or coexist with different systemic syndromes. Nevertheless, significant controversy surrounds treating this disease when combined with hip dislocation. This paper presents a case of a 4-month-old patient diagnosed with bilateral hip dislocation combined with this disease. The study discusses the pathophysiology, diagnosis, and treatment methods and reviews relevant literature. Case presentation We reported a case of a 4-month-old female infant with congenital dislocation of the right knee joint, which presented as flexion deformity since birth. Due to limitations in local medical conditions, she did not receive proper and effective diagnosis and treatment. Although the flexion deformity of her right knee joint partially improved without treatment, it did not fully recover to normal. When she was 4 months old, she came to our hospital for consultation, and we found that she also had congenital dislocation of both hip joints and atrial septal defect. We performed staged treatment for her, with the first stage involving surgical intervention and plaster orthosis for her congenital dislocation of the right knee joint, and the second stage involving closed reduction and plaster fixation orthosis for her congenital hip joint dislocation. Currently, the overall treatment outcome is satisfactory, and she is still under follow-up observation. Conclusions Early initiation of treatment is generally advised, as nonsurgical methods prove satisfactory for mild cases. However, surgical intervention should be considered in cases with severe stiffness, unresponsive outcomes to conservative treatment, persistent deformities, or diagnoses and treatments occurring beyond the first month after birth.

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Section: Discussionmentioning

confidence: 99%

Congenital dislocation of the knee complicated with bilateral hip dislocation: a case report and literature review

Qi,

Jie,

Wang

et al. 2024

BMC Musculoskelet Disord

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“…Various treatments for CKD have been described, including closed reduction, physiotherapy, serial casting, minimally invasive or open quadricepsplasty and femoral shortening 6,[24][25][26][27][28][29][30][31][32] . The success rate of manipulation is 77%, and the outcome improves further after treatment with serial casting 25 .…”

Section: Discussionmentioning

confidence: 99%

Prenatal diagnosis and postnatal outcome of fetal congenital knee dislocation: systematic review of literature

Cavoretto,

Castoldi,

Corbella

et al. 2023

Ultrasound in Obstet & Gyne

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ObjectivesCongenital Knee Dislocation (CKD) or Genu Recurvatum is a rare condition affecting 1 over 100,000 newborns, characterized by anterior hyperextension of the knee joint, increased transverse skin folds over the anterior surface of the knee and prominence of femoral condyles into the popliteal fossa. Prenatal diagnosis is poorly described in the literature and challenging, especially when it appears isolated and not in the context of polymalformative or syndromic patterns. The purpose of this study is to provide a comprehensive review of the available literature on prenatal diagnosis and postnatal outcome of this rare condition, to summarize the current evidence on this topic.MethodsWe performed a systematic review of the literature searching for prenatal diagnosis of CKD in all major internet‐based medical databases. A predefined combination of specific key words was used, focusing on intrauterine manifestations, diagnostic methods, prenatal behavior, postnatal treatment and neonatal outcome as well as long‐term outcome on ambulation, motion and joint stability. Study quality was assessed by means of National Institute of Health tool for the quality assessment of Case Series Studies. A summary of results was carried out providing proportions and rates of diagnostic and prognostic features associated with this rare condition.ResultsTwenty cases were retrieved for analysis including nineteen collected from the systematic review and one unpublished case from our experience. Median gestational age at prenatal diagnosis was 22 weeks (range 14‐38 weeks), generally by US. Bilaterality was observed in 11/20 (55%), the condition was isolated in 7/20 cases (35%) and associated to other anomalies in 13/20 cases (65%). An association was observed with oligohydramnios (20%) and invasive procedures were performed in 11 cases (55 %). Genetic studies were normal in all isolated cases and few genetic syndromes were present in 10 of the 13 (77%) non‐isolated cases for which information was available (Larsen, Noonan, Grebe, Desbuquois and Escobar syndromes). There were 7 terminations of pregnancy, of which 6 with associated anomalies and one isolated, 11 livebirths, one intrauterine death and one neonatal death. All fetal or neonatal demises were in fetuses with associated anomalies or abnormal genetics. Postnatal treatment was essentially conservative with only two reports (18% of the 11 liveborn neonates) of surgical interventions, all in cases with associated anomalies. The postnatal follow up was in most of the cases up to the first year and the motor outlook appears normal.ConclusionsCKD is a rare fetal anomaly with a prenatal diagnosis achievable from the early second trimester for which favorable outcome can be predicted when no associated anomalies are present. Prenatal diagnosis should include detailed US assessment and amniocentesis for extensive genetic studies, particularly in non‐isolated cases. Postnatal early treatment achieves success in most cases without surgical intervention and leads to normal motor outlook.This article is protected by copyright. All rights reserved.

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“…However, the invasive nature of the procedures is associated with complications like wound dehiscence, extensor lag, and flexion contracture. 9 For this reason, the authors believe that a proper attempt at closed reduction must be performed before embarking on surgical intervention. In recalcitrant knee dislocations such as in this current report, it is crucial to maintain the anteriorly directed force on the femoral condyles throughout the procedure to ensure that reduction is not lost while applying the cast.…”

Section: Discussionmentioning

confidence: 99%

“…In grade III or in case of failure of conservative treatment, surgical procedures like percutaneous quadriceps tenotomy or VY quadriceps lengthening is advocated. However, the invasive nature of the procedures is associated with complications like wound dehiscence, extensor lag, and flexion contracture 9. For this reason, the authors believe that a proper attempt at closed reduction must be performed before embarking on surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Recalcitrant congenital knee dislocation: a case report of successful serial casting in a dysmorphic infant

Hussaini

Chandirasegaran

Yusof

et al. 2022

Current Orthopaedic Practice

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Congenital knee dislocation. Therapeutic protocol and long-term functional results

Cited by 4 publications

References 10 publications

Congenital dislocation of the knee complicated with bilateral hip dislocation: a case report and literature review

Congenital dislocation of the knee complicated with bilateral hip dislocation: a case report and literature review

Prenatal diagnosis and postnatal outcome of fetal congenital knee dislocation: systematic review of literature

Recalcitrant congenital knee dislocation: a case report of successful serial casting in a dysmorphic infant

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