Bilateral congenital knee dislocation: A case report

Introduction: Congenital knee dislocation (CDD) is a rare musculoskeletal anomaly characterized by fixed hyperextension of the knee joint and limited passive flexion. It has a multifactorial etiology. Diagnosis is primarily clinical, and initial management is usually conservative. 

Materials and methods: We present a case report of a newborn diagnosed with bilateral congenital knee dislocation. 

Results: A 37-week-old female neonate, born via eutocic vaginal delivery, presented with hyperextension of both knees at an angle of approximately 60° on physical examination, with an anterior crease and passive flexion of 5-10°. Palpation revealed a small patella deep to the crease on the anterior aspect of the knees. A comparative knee radiograph showed anterior knee subluxation, and a Doppler ultrasound of the knees was performed. Physical changes, including color and oxygen saturation of the distal extremity, were monitored, but no abnormalities were detected. Therefore, conservative management was chosen, using a flexor-abductor harness. Subsequent normal positioning of both knees was achieved, and the patient progressed to active and passive ranges of motion of -5° to 120°, without recurrence of the dislocation during outpatient follow-up. 

Conclusion: The case presented demonstrates that early diagnosis and appropriate conservative intervention can lead to spontaneous reduction and complete functional recovery, avoiding the need for surgical procedures.