Congenital Dislocation of the Knee in a 16-Year-Old Girl

abstract Full article available online at OrthoSuperSite.com/view.aspx?rID=63287 Congenital Dislocation of the Kneein a 16-Year-Old Girl S EYYED M ORTEZA K AZEMI , MD; M OHAMMAD R EZA A BBASIAN , MD; H AMID R EZA S EYYED H OSSEINZADEH , MD; R AMIN F ARHANG Z ANGANEH , MD; A LIREZA E AJAZI , MD; L ALEH D AFTARI B ESHELI , MD Drs Kazemi, Seyyed Hosseinzadeh, Eajazi, and Daftari Besheli are from Akhtar Orthopaedic Re-search Center, Akhtar Orthopaedic Hospital, and Drs Abbasian and Farhang Zanganeh are from Akhtar Orthopaedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Drs Kazemi, Abbasian, Seyyed Hosseinzadeh, Farhang Zanganeh, Eajazi, and Daftari Besheli have no relevant fi nancial relationships to disclose.Correspondence should be addressed to: Mohammad Reza Abbasian, MD, Akhtar Orthopaedic Hospital Research Center, Elahieh, Tehran, Iran (mohammadreza.abbasian@gmail.com).doi: 10.3928/01477447-20100329-22 Congenital dislocation of the knee ranges from hyperextension of the knee to transla-tion of the femur on the tibia. Treatment options include bracing, splinting, manipula-tion and casting, and surgery.A 16-year-old girl presented with an inability to walk, stand upright, or bend her knees. She exhibited deformity of both lower extremities. She had deformed knees from birth, and they had been put in a cast for 2 months. No other therapeutic measures were taken. The patient walked on her abnormally hyperextended knees and could hyper-extend the knees to 150 recurvatum. She was diagnosed with a grade III congenital dislocation of the knee, and a fl exion-shortening osteotomy at the distal femur above the trochlear level was performed on her knees in 2 sessions. Postoperatively, range of motion changed from hyperextention to 80 fl exion. A femoral supracondylar oste-otomy was also performed 2 years later, and as a result, a 15 fl exion and 15 valgus were added to the limb. The patient is now able to stand and walk without a knee brace and has 90 passive and 80 active knee fl exion on both sides.Congenital dislocation of the knee is a rare congenital disorder. The results of treat-ment are favorable if started before age 3 months, or sometimes before age 2 years, but there is no effective treatment for older, neglected cases; therefore, we believe this case report demonstrates a novel surgical approach.