Congenital Dislocation of the Knee

Topic updated on 12/12/14 3:46pm
  • Spectrum of disease including
    • positional contractures
    • rigid dislocation
  • Structural components include
    • quadricep tendon contracture
    • anterior subluxation of hamstring tendon
    • absent suprapatellar pouch
    • tight collateral ligament
  • Often occurs in children with
    • myelomeningocele
    • arthrogryposis
    • Larsen's syndrome
  • Associated conditions
    • often associated with developmental dysplasia of the hip, clubfoot, and metatarsus adductus
      • 50% of patients with congenital knee dislocations will have hip dysplasia affect one or both hips
  • Presents with hyperextened knee at birth
  • Nonoperative treatment
    • reduction with manual manipulation and casting
      • indications
        • most cases can be treated nonoperatively
        • if both knee and hip dislocated, then treat knee first
          • cant get Pavlik harness on hip if knee dislocated
      • technique
        • long leg casting on weekly basis
  • Operative treatment
    • surgical soft tissue release
      • indications
        • if failure to gain 30 degrees of flexion after 3 months of casting
      • goal of surgery is to obtain 90 degrees of flexion with
        • quadriceps tendon lengthening (V-Y quadricepsplasty or Z lengthening) 
        • anterior joint capsule release
        • hamstring tendon posterior transposition
        • collateral ligaments mobilization
      • postoperative
        • cast in 45 to 60 degrees of flexion for 3 to 4 weeks


Please Rate Educational Value!
Average 3.0 of 15 Ratings

Qbank (1 Questions)

Sorry, this question is available to Virtual Curriculum members only.

Click HERE to learn more and purchase the Virtual Curriculum today!


Topic Comments