Congenital dislocation of the knee: a morphological study
- Authors: Kruglov I.Y.1, Agranovich O.E.2, Rumyantsev N.Y.1, Razmologova O.Y.1, Kolobov A.V.3, Omarov G.G.4, Kleshch D.S.5, Rumiantceva N.N.1
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Affiliations:
- Almazov National Medical Research Centre
- H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
- St. Petersburg State University
- H. Turner National Medical Research Centre for Children’s Orthopedics and Trauma Surgery
- Children’s Regional Clinical Hospital
- Issue: Vol 8, No 4 (2020)
- Pages: 427-435
- Section: Original Study Article
- URL: https://journals.eco-vector.com/turner/article/view/25809
- DOI: https://doi.org/10.17816/PTORS25809
- ID: 25809
Cite item
Abstract
Background. Congenital knee dislocation is a rare disease of the musculoskeletal system (1 in 100,000 live births). In the literature, few studies have described the anatomical changes characteristic of this pathology, which are only revealed during surgical treatment.
Aim. This study aimed to evaluate the pathomorphological features of the ligamentous–articular apparatus and thigh muscles with congenital knee dislocation on autopsy material.
Materials and methods. The study included two fetuses with bilateral congenital knee dislocation after spontaneous miscarriage at 18 and 20 weeks of gestation and one stillborn fetus with bilateral congenital knee dislocation at 29 weeks of gestation. The comparison group was composed of two fetuses after spontaneous miscarriages at 18 and 20 weeks of gestation and one stillborn fetus at 25 weeks of gestation without anomalies of the lower extremities.
Results. Various abnormalities and displacements of the anatomical structures, as well as degenerative dystrophic changes in the soft tissues during histological examination, were found. Pathomorphological changes in the control group were not detected.
Conclusion. Pathomorphological changes are the main manifestations of congenital knee dislocation in the studied fetuses.
Full Text
About the authors
Igor Yu. Kruglov
Almazov National Medical Research Centre
Author for correspondence.
Email: dr.gkruglov@gmail.com
ORCID iD: 0000-0003-1234-1390
MD, paediatric orthopaedic surgeon, junior researcher of Research Laboratory of Congenital and Hereditary Pathology Surgery
Russian Federation, Saint PetersburgOlga E. Agranovich
H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery
Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
SPIN-code: 4393-3694
http://www.rosturner.ru/kl10.htm
MD, PhD, D.Sc., Supervisor of the Department of Arthrogryposis
Russian Federation, Saint PetersburgNicolai Yu. Rumyantsev
Almazov National Medical Research Centre
Email: dr.rumyantsev@gmail.com
ORCID iD: 0000-0002-4956-6211
MD, Paediatric Orthopaedic Surgeon
Russian Federation, Saint- PetersburgOlga Yu. Razmologova
Almazov National Medical Research Centre
Email: or1973@yandex.ru
ORCID iD: 0000-0001-7073-899X
MD, PhD, pathologist, Head of the Department of Pathological Anatomy Polenov Russian Neurosurgical Institute
Russian Federation, Saint PetersburgAndrey V. Kolobov
St. Petersburg State University
Email: pathandrey@rambler.ru
ORCID iD: 0000-0003-3713-7484
MD, PhD, pathologist, Associate Professor, Department of Pathology, Faculty of Medicine
Russian Federation, Saint PetersburgGamzat G. Omarov
H. Turner National Medical Research Centre for Children’s Orthopedics and Trauma Surgery
Email: ortobaby@yandex.ru
ORCID iD: 0000-0002-9252-8130
MD, PhD, Research Associate
Russian Federation, Saint-PetersburgDanil S. Kleshch
Children’s Regional Clinical Hospital
Email: danilklesh@mail.ru
ORCID iD: 0000-0002-4903-985X
MD, paediatric orthopaedic surgeon
Russian Federation, KrasnodarNatalia N. Rumiantceva
Almazov National Medical Research Centre
Email: natachazlaya@mail.ru
ORCID iD: 0000-0002-2052-451X
MD, Paediatric Orthopaedic Surgeon, Junior Researcher of Research Laboratory of Congenital and Hereditary Pathology Surgery
Russian Federation, Saint- PetersburgReferences
- Curtis BH, Fisher RL. Congenital hyperextension with anterior subluxation of the knee. Surgical treatment and long-term observation. J Bone Surg Am. 1969;51(2):255-269. https://doi.org/10.2106/00004623-196951020-00005.
- Katz MP, Grogono BJ, Soper KC. The etiology and treatment of congenital dislocation of the knee. J Bone Joint Surg Br. 1967;49(1):112-120. https://doi.org/10.1302/0301-620x.49b1.112.
- Laurence M. Genu recurvatum congenitum. J Bone Surg. 1967;49(1):121-134. https://doi.org/10.1302/0301-620x.49b1.121.
- Niebauer J, King E. Congenital dislocation of the knee. J Bone Joint Surg Am. 1960;42:207-225. https://doi.org/10.2106/00004623-196042020-00002.
- Tachdjian MO. Pediatric orthopaedics. 2nd ed. Philadelphia: W.B. Saunders; 1990.
- Potel GF. Etude sur Les Malformations Congenitales du Genou. [dissertation] Danel; 1897.
- Jacobsen K, Vopalecky F. Congenital dislocation of the knee. Acta Orthop Scand. 1985;56(1):1-7. https://doi.org/10.3109/17453678508992968.
- Bensahel H, Dal Monte A, Hjelmstedt A, et al. Congenital dislocation of the knee. J Pediatr Orthop. 1989;9(2):174-177.
- Middleton DS. The pathology of congenital genu recurvatum. Br J Surg. 1935;22(88):696-702. https://doi.org/10.1002/bjs.1800228807.
- Patwardhan S, Shah K, Shyam A, Sancheti P. Assessment of clinical outcome ofpercutaneous needle quadriceps tenotomy in the treatment of congenital knee dislocation. Int Orthop. 2015;39(8):1587-1592. https://doi.org/10.1007/s00264-015-2806-7.
- Matar HE, Garg NK. Management of joint dislocation of the lower limb in Larsen syndrome: Practical approach. Ann R Coll Surg Engl. 2017;99:e8-e10. https://doi.org/10.1308/rcsann.2016.0258.
- Youssef AO. Limited open quadriceps release for treatment of congenital dislocation of the knee. J Pediatr Orthop. 2017;37(3):192-198. https://doi.org/10.1097/bpo.0000000000000612.
- Madadi F, Tahririan MA, Karami M, Madadi F. Complicated congenital dislocation of the knee: A case report. Arch Bone Jt Surg. 2016;4(4):396-398.
- Kaissi AA, Ganger R, Klaushofer K, Grill F. The management of knee dislocation in a child with Larsen syndrome. Clinics (Sao Paulo). 2011;66(7):1295-1299. https://doi.org/10.1590/s1807-59322011000700030.
- Tercier S, Shah H, Joseph B. Quadricepsplasty for congenital dislocation of the knee and congenital quadriceps contracture. J Child Orthop. 2012;6(5):397-410. https://doi.org/10.1007/s11832-012-0437-8.
- Uhthoff HK, Ogata S. Early intrauterine presence of congenital dislocation of the knee. J Pediatr Orthop. 1994;14(2):254-257. https://doi.org/10.1097/01241398-199403000-00023.
- Кондратьев С.А., Забродская Ю.М., Размологова О.Ю., и др. Патоморфологические особенности полинейропатии критических состояний у пациентов в персистирующем вегетативном состоянии и состоянии «малого сознания» // Российский нейрохирургический журнал имени проф. Л.А. Поленова. – 2013. – Т. 5. – № 4. – С. 48–53. [Kondratyev SA, Zabrodskaya YM, Razmologova OY, et al. Pathomorphological features of critical illness polyneuromyopathy in patients with persistent vegetative state and “small state of consciousness”. Russian neurosurgical journal named after professor A.L. Polenov. 2013;5(4):48-53. (In Russ.)]
- Fernandez-Palazzi F, Silva JR. Congenital dislocation of the knee. Int Orthop. 1990;14(1):17-19. https://doi.org/10.1007/bf00183357.
- Provenzano F. Congenital dislocation of the knee; report of a case. N Engl J Med. 1947;236(10):360-362. https://doi.org/10.1056/nejm194703062361003.
- McFarland BL. Congenital dislocation of the knee. J Bone Joint Surg. 1929;11(2):281-285.
- Корлякова М.Н., Воронин Д.В., Карпов К.П., Румянцев Н.Ю. Изолированный врожденный вывих коленного сустава, ультразвуковая пренатальная диагностика и исходы: описание клинических наблюдений // Медицинская визуализация. – 2014. – № 1. – С. 110–117. [Korlyakova MN, Voronin DV, Karpov KP, Rumyantsev NY. Isolated congenital dislocation of the knee, ultrasound prenatal diagnosis and outcomes: description of clinical cases. Medical visualization. 2014;(1):110-117. (In Russ.)]
- Gorincour G, Chotel F, Rudigoz RC, et al. Prenatal diagnosis of congenital genu recurvatum following amniocentesis complicated by leakage. Ultrasound Obstet Gynecol. 2003;22(6):643-645. https://doi.org/10.1002/uog.884.
- Barber MA, Equiluz I, Plasencia W, et al. Prenatal features of genu recurvatum and genu flexum. Int J Gynaecol Obstet. 2009;105(3):267-268. https://doi.org/10.1016/j.ijgo.2009.01.015.
- Lage JA, Guarniero R, de Barros Filho TE, de Camargo OP. Intrauterine diagnosis of congenital dislocation of the knee. J Pediatr Orthop. 1986;6(1):110-111. https://doi.org/10.1097/01241398-198601000-00023.
- Elchalal U, Itzhak IB, Ben-Meir G, Zalel Y. Antenatal diagnosis of congenital dislocation of the knee: A case report. Am J Perinatol. 1993;10(3);194-196. https://doi.org/10.1055/s-2007-994717.
- Bell MJ, Atkins RM, Sharrad WJ. Irreducible congenital dislocation of the knee. Aetiology and management. J Bone Joint Surg Br. 1987;69(3):403-406. https://doi.org/10.1302/0301-620x.69b3.3584194.
- Johnson E, Audell R, Oppenheim WL. Congenital dislocation of the knee. J Pediatr Orthop. 1987;7(2):194-200. https://doi.org/10.1097/01241398-198703000-00017.
- Bensahel H, Dal Monte A., et al. Congenital dislocation of the knee. J Pediatr Orthop. 1989;9:174-177. https://doi.org/10.1097/01202412-198909020-00011.