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

J Salvador Marín; C Miranda Gorozarri; R M Egea-Gámez; J Alonso Hernández; S Martínez Álvarez; Á Palazón Quevedo

doi:10.1016/j.recot.2020.07.007

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

Rev Esp Cir Ortop Traumatol (Engl Ed). 2021 May-Jun;65(3):172-179. doi: 10.1016/j.recot.2020.07.007. Epub 2021 Jan 5.

[Article in English, Spanish]

Authors

J Salvador Marín¹, C Miranda Gorozarri², R M Egea-Gámez², J Alonso Hernández², S Martínez Álvarez², Á Palazón Quevedo²

Affiliations

¹ Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España. Electronic address: salvadormarinj@gmail.com.
² Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Niño Jesús, Madrid, España.

PMID: 33414098
DOI: 10.1016/j.recot.2020.07.007

Abstract

Background and objective: Congenital knee dislocation is a very rare entity, characterised by deformity in knee recurvatum present at birth, and there is currently no consensus on the optimal treatment. The aim of the present study is to analyse the functional results and long-term complications after the application of a protocol of therapeutic action for the management of congenital knee dislocation (CKD) created in a reference centre for child orthopaedics.

Materials and methods: Retrospective descriptive study of patients with congenital dislocation of the knee who followed CRPL between January 1997 and December 2010. Demographic variables, type of treatment, functional outcomes at the end of the follow-up, complications and relapses were studied. The conservative treatment consisted of serial casts, leaving the surgical treatment for cases in which passive flexion was not achieved above 30° or the conservative treatment failed.

Results: 9 patients (11 knees) met the inclusion criteria. The 66.7% were girls and the average follow-up was 15 years (9-22). In all cases, conservative treatment was initiated. Of the 11 knees treated, less than half (36%) required surgery. The average Lysholm questionnaire was 90.3 points, the WOMAC pain 0.4 (0-1), WOMAC stiffness 1.8 (0-6) and WOMAC function 3.8 (1-12).

Conclusions: The existence and application of the PLCR protocol in a pathology as rare as congenital knee dislocation suggests good long-term functional results with few complications and no recurrences.

Keywords: Congenital knee dislocations; Knee joint; Luxación congénita de rodilla; Protocolos terapéuticos/clínicos; Rodilla; Treatment/clinical protocols.