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Congenital knee dislocation

Definition

Profound hyperextension and posterior dislocation of the tibia and fibula on the femur, detectable in utero or at the time of birth. It can be unilateral or bilateral and is thought to be secondary to intrauterine positioning causing hyperextension of the legs. In 70 to 90% of the cases, there is also an ipsilateral congenital dislocation of the hip. In most cases, some reduction of the deformity is possible but the knee cannot be brought into flexion due to fibrosis and contracture of the quadriceps muscle. In severe cases with dislocation of the tibia, the tibial plateau can be palpated anterior to the femur and cannot be reduced. The patella may be palpable. The quadriceps muscle in the involved extremity is usually atrophic. Although congenital dislocation of the knee has been found in association with a number of syndromes such as Larsen's syndrome, myelodysplasia, Ehlers' Danlos syndrome, Streeter's syndrome, and arthrogryposis, it is not