La luxación congénita de rodilla (LCR) es una anomalía musculoesquelética poco frecuente, caracterizada por hiperextensión de la rodilla al nacimiento. Sus posibles causas incluyen factores mecánicos, como el oligoamnios o la presentación podálica, así como alteraciones genéticas o neuromusculares. El objetivo fue describir la incidencia, características clínicas, tratamiento y resultados de los casos de LCR diagnosticados en una unidad neonatal del norte de España durante un periodo de 20 años. Se llevó a cabo un estudio observacional, descriptivo y retrospectivo de casos de LCR diagnosticados entre 2005 y 2024 (43,500 nacimientos). Se analizaron variables demográficas, obstétricas, clínicas, terapéuticas y de complicaciones, obtenidas de los historiales clínicos e imágenes diagnósticas. Se identificaron ocho pacientes (11 rodillas afectadas), con una incidencia del 0.02%. La edad gestacional media fue de 37 semanas y el peso medio al nacer de 2,435 gramos. El 75% de los casos correspondieron a niñas, con afectación bilateral en el 37.5% y predominio de la rodilla izquierda. Se observó oligoamnios en el 25% y presentación podálica en el 37.5% de los casos. La displasia del desarrollo de cadera fue la comorbilidad más frecuente (37.5%). Todos los pacientes fueron tratados de forma conservadora mediante yesos seriados, con resultados favorables en seis de ellos. Un caso requirió tratamiento ortésico prolongado por malformaciones complejas y otro presentó una leve discrepancia en la longitud de las extremidades. El diagnóstico precoz, habitualmente mediante exploración física, es esencial para un pronóstico favorable. El tratamiento conservador resulta eficaz en la mayoría de los casos, reservándose la cirugía para situaciones refractarias. La incidencia observada fue superior a la descrita clásicamente, lo que podría reflejar variaciones metodológicas o poblacionales. La evaluación integral de los pacientes es fundamental para identificar anomalías asociadas y prevenir complicaciones a largo plazo. Congenital knee dislocation (CKD) is a rare musculoskeletal anomaly characterized by hyperextension of the knee at birth. Its possible etiologies include mechanical factors, such as oligohydramnios or breech presentation, as well as genetic or neuromuscular abnormalities. The objective was to describe the incidence, clinical characteristics, management, and outcomes of CKD cases diagnosed in a neonatal unit in northern Spain over a 20-year period. We conducted an observational, descriptive, and retrospective study including all cases of congenital knee dislocation diagnosed between 2005 and 2024 (43,500 live births). Demographic, obstetric, clinical, therapeutic, and complication variables were analyzed based on medical records and diagnostic imaging. Eight patients (11 affected knees) were identified, with an incidence of 0.02%. The mean gestational age was 37 weeks, and the mean birth weight was 2,435 grams. Seventy-five percent of patients were female, with bilateral involvement in 37.5% and a predominance of left-sided dislocation. Oligohydramnios was observed in 25% of cases and breech presentation in 37.5%. Developmental dysplasia of the hip was the most frequent comorbidity (37.5%). All patients were treated conservatively with serial casting, achieving favorable outcomes in six. One patient required prolonged orthotic management due to complex malformations, and another presented a mild limb-length discrepancy. Early diagnosis, typically through physical examination, is essential for a favorable prognosis. Conservative treatment is effective in most cases, while surgery should be reserved for refractory situations. The incidence observed was higher than previously reported, which may reflect methodological or population-based differences. Comprehensive patient evaluation is crucial to identify associated anomalies and prevent long-term complications.

Congenital knee dislocation (CKD) is a rare anomaly characterized by anterior and lateral displacement of the tibia in relation to the femur. Its incidence is 0.017 per 1000 live births, predominating in the female sex. Its etiology is unknown, but intrinsic (genetic) and extrinsic (mechanical) predisposing factors have been identified. Treatment ranges from conservative measures to surgery, depending on the severity of the case. This study aims to present a case of CKD not associated with other pathologies and highlight its favorable progression through timely diagnosis and conservative management. We present a full-term newborn with a diagnosis of left CKD. Physical examination revealed genu recurvatum in reducible hyperextension. The x-ray confirmed grade III dislocation. Manual reduction was performed with immobilization by means of a thigh splint, with improvement after 7 days. At 5 months, the patient presented satisfactory evolution without functional limitations. CKD has three severity grades and various causes. Diagnosis is made clinically and radiographically, and sometimes prenatally. Grades I-II are treated conservatively; grade III or non-improving cases may require surgery. Early detection improves prognosis.

Congenital dislocation of the knee (CDK) is a rare condition, often associated with syndromes and other limb anomalies. It is typically diagnosed and treated in early infancy. Neglected cases of CDK can present with significant deformities and loss of function. Their treatment is challenging and scarcely reported in the literature. The primary purpose of this study is to report on management of neglected CDK presenting in second decade of life. Four patients (eight knees) with severe, neglected, bilateral CDK who presented in their second decade of life were identified. Their preoperative radiographs were evaluated for presence of distal femoral dysplasia and compared to age-matched controls. Their clinical presentation, surgical treatment, and outcomes were analyzed at minimum 2 year follow-up. All four patients were 11-12 years old and had severe, bilateral, neglected CDK. Three patients had a quadrupedal gait. Preoperative radiographs showed significant distal femoral dysplasia when compared to controls. Surgical interventions included bilateral open reduction with quadricepsplasty in two patients and femoral flexion-shortening osteotomy (FSO) in two patients. At the latest follow-up, all patients had bipedal gait and improved quality of life. Postoperative radiographs showed improvement in distal femoral dysplasia in patients who underwent open reduction and quadricepsplasty. Patients with neglected CDK can present with quadrupedal gait. Compared to femoral FSO, open reduction and quadricepsplasty appears to be a better surgical treatment option as the latter can help restore joint articulation. Once the joint is reduced, distal femoral dysplasia can remodel to a certain extent. Level of evidence: Case series - Level 4.

Congenital knee dislocation (CKD) is a rare musculoskeletal condition that may occur in isolation or be associated with other congenital abnormalities. Prognosis depends on the severity of the deformity and the timing of diagnosis and treatment. Comprehensive assessment and close follow‑up are essential to optimize recovery and to exclude associated anomalies. We report the case of a female newborn with CKD, diagnosed postnatally, associated with developmental dysplasia of the hip (DDH), generalized ligamentous laxity, congenital heart disease, and a chromosomal abnormality. Early conservative management, started in the first hour of life, resulted in successful reduction and complete recovery of knee mobility.

Congenital knee dislocation (CKD) (genu recurvatum congenitum) is a rare neonatal orthopedic deformity characterized by hyperextension of the knee joint and potentially associated with intrauterine mechanical factors, quadriceps contracture, or syndromic disorders. Early recognition is essential, as prompt conservative management can prevent long-term disability and reduce the need for surgical intervention. The objective of this single case report is to describe a rare presentation of bilateral congenital knee dislocation managed successfully through early conservative treatment in a rural and resource-limited setting of Nepal, highlighting the timeline of improvement and long-term outcome. We report a full-term female neonate born via institutional delivery in a remote region of Dailekh District, Nepal, who presented within 24 hours of birth with bilateral knee hyperextension of approximately 100°, consistent with type II congenital knee dislocation (anterior tibial subluxation without complete dislocation). The neonate was treated with gentle manipulation and serial above-knee plaster casting, with casts changed every 7-10 days to gradually increase knee flexion from 0° to 30°, while the toes were left exposed for monitoring of circulation and swelling due to the remote location of the patient's family. Noticeable improvement was observed after three casting sessions over a four-week period, and by six weeks, both knees achieved near-neutral to mildly flexed resting positions, demonstrating improved alignment and stability. Follow-up radiographs at six weeks, six months, two years, and four years confirmed maintained reduction, normal knee alignment, intact growth plates, and age-appropriate motor milestones without pain, instability, or functional limitations. This case highlights that early diagnosis and conservative management of congenital knee dislocation can achieve excellent long-term anatomical and functional outcomes, even in resource-limited settings and during challenging circumstances, emphasizing the importance of continuous follow-up and parental counseling to ensure adherence and awareness in managing rare congenital orthopedic conditions.