Between February 1988 and June 1995, 24 congenital dislocations of the knee joints (17 patients) were reduced with closed methods including immediate reduction, serial casting, or traction in patients from 10 min to 26 days old. At an average follow-up of 4 years and 10 months, an excellent or good result was achieved if there were no associated anomalies. Fair or poor results were the result of delayed treatment or associated musculoskeletal anomalies including arthrogryposis multiplex congenita or Larsen's syndrome. Routine check of the hip dislocation is suggested. Diagnosis with manual testing was difficult, and other methods such as radiography or sonography were suggested in combination to detect hip dysplasia. The dislocated knee should be reduced before treating the hip dislocation. Concomitant treatment of the congenital dislocation of the knee and the hip with Pavlik harness provided satisfactory results. When late, progressive, genu valgus deformity occurred because of global instability of the knee and asymmetric physeal growth, reconstruction of the medial structures of the knee and prolonged bracing provided good results.
Study conducted at Chang-Gung Memorial Hospital Kaohsiung, Taiwan, R.O.C.
From Orthopedic Department, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, 833 Taiwan, R.O.C.; and *Orthopedic Department, Children's Hospital-San Diego and University of California-San Diego, 3030 Children's Way, Suite 410, San Diego, CA 92123, U.S.A.
Address correspondence and reprint requests to Dr. J-Y. Ko, Orthopedic Department, 123 Ta-Pei Raod, Niao-sung Hsiang, Kaohsiung Hsien, 833, Taiwan, R.O.C.