| Introduction |
 Spectrum of disease including
- positional contractures
- rigid dislocation
- Structural components include
- quadricep tendon contracture
- anterior subluxation of hamstring tendon
- absent suprapatellar pouch
- tight collateral ligament
- Often occurs in children with
- myelomeningocele
- arthrogryposis
- Larsen's syndrome
- Associated conditions
- often associated with developmental dysplasia of the hip, clubfoot, and metatarsus adductus
- 50% of patients with congenital knee dislocations will have hip dysplasia affect one or both hips
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| Presentation |
- Presents with hyperextened knee at birth
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| Treatment |
- Nonoperative treatment
- reduction with manual manipulation and casting
- indications
- most cases can be treated nonoperatively
- if both knee and hip dislocated, then treat knee first
- cant get Pavlik harness on hip if knee dislocated
- technique
- long leg casting on weekly basis
- Operative treatment
- sugical soft tissue release
- indications
- if failure to gain 30 degrees of flexion after 3 months of casting
- goal of surgery is to obtain 90 degrees of flexion with
- quadriceps tendon lengthening (V-Y quadricepsplasty or Z lengthening)
- anterior joint capsule release
- hamstring tendon posterior transposition
- collateral ligaments mobilization
- postoperative
- cast in 45 to 60 degrees of flexion for 3 to 4 weeks
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