Developmental abnormalities of the knee fall in the category of rare congenital malformations and usually in combination with other injuries of the musculoskeletal system: underdevelopment or deformity of the bones of the feet, hypoplasia, or shortening of the hamstrings, etc, to find out the cause of these abnormalities is often not possible. It is assumed that most of the defects of the knee is due to genetic disorders or as a consequence of unfavourable external factors on the process of normal embryogenesis. Diagnosis is based on the results of the examination, and radiographic studies. Treatment in most cases should start from the first days of life. In some cases, irregularities can be addressed by conservative. Sometimes requires surgical correction.
Developmental disorders of the knee – a relatively rare group of congenital anomalies of the lower extremities. Usually in trauma and orthopaedics is a combination of abnormalities of the knee joint, with underdevelopment of the bones and muscles of the other parts of the extremities, but may occur in some of the gaps. It is often revealed similar pathological changes in both lower extremities. Perhaps the underdevelopment of the bony structures, and congenital dislocations and subluxations, contractures, or, on the contrary, excessive mobility.
The main cause for the occurrence of injury to knees and other parts of the musculoskeletal system, genetic disorders and adverse external influences on the mother's body during pregnancy. Among these influences:
The nature of the defect depends on the type of gene mutation or from time to harmful external influences on the human body. If the mother was exposed in the first trimester of pregnancy, there is a lack of structure for the knee (errors, bookmarks), if on the day of their own underdevelopment.
As isolated, the condition is very rare. Usually combined with hypoplasia of the tibial tuberosity, condyles of the femur and quadriceps. Often, when this anomaly is observed, the dislocation of the tibia, dislocation of hip, clubfoot, damage or underdevelopment of the bones of the Shin and thigh. In the case of isolated pathology of the limb function is almost not broken, shows visible defects on the front surface of the joint. A potential weakness in the legs and premature fatigue during prolonged walking. In patients with isolated anomalies do not require treatment. In combination with other malformations is early, conservative and/or surgical treatment.
Is observed at 1.5-2% of individuals underwent radiography in the knee. Usually becomes a random search on examination by a orthopedist or rheumatologist in respect of injury or other diseases that are common. In 90% of cases affect men. When this anomaly is the patella is composed of several parts, and its size and outer shape of the normal. The more common double-lobed, rarely trilobate patella. Usually, a special treatment is required, however, due to the predisposition to trauma and subsequent development of osteoarthritis of the patients with this pathology, the need to be careful when playing sports and intense physical activity.
In some cases, inherited. Often in combination with other anomalies of the limb. Boys suffer twice as often as girls. Patients complain of fatigue and instability when walking. The review showed a shift of the kneecap (usually the outer) and a pronounced strain to the quadriceps. Movement in the joint is limited. With age develops a gradual deviation of the tibia outwards (X-form) is deforming arthrosis.
On radiographs in the knee to detect the shift and patellar hypoplasia (reduction in size, irregular shape), flattening and hypoplasia outer condyles of the tibia and the femur. MRI of the knee joint and the femur is determined by the underdevelopment of medial broad the thigh muscles, in some cases, this muscle is absent. Operational treatment: own cruciate ligament in the patella is moved to the front side of the thigh and is fixed in the chest.
A very rare anomaly. Usually detected simultaneously from two sides. Girls suffer three times more often than boys. Observed deformation and muscle atrophy, the nature of the injury depends on the type of shift of the tibia. When the front of the dislocation of the condyles of the femur will stand to the rear, rear – to- front. Determine the severe flexion contracture and excessive lateral movement of the lower leg. In the flexors of the tibia are usually shorter, while the extensors are shifted anteriorly. The joint is bent or directed forward. The error is usually associated with hypoplasia or absence of the cruciate ligaments, therefore, showed positive symptom of "drawer". Perhaps the underdevelopment and the violation of attachment of other muscles. Congenital dislocation of the tibia is sometimes observed in conjunction with anomalies of the ankle joint and the lack of the tibia.
There are three stages of subluxation:
On radiographs is determined by the dislocation and hypoplasia of the tibia, deviation, and rotation of the bones of the lower leg inward or outward (depending on the degree of hypoplasia of the lateral surface of the joint side of the tibia). In some cases, further appointed MRI and CT of the knee joint to better assess the degree of underdevelopment of the bones and soft tissues of the thigh, the shins and the knee.
The treatment is carried out in the Department of pediatric orthopedics and begins with the first days of life. Infants learn about traction in length with subsequent closed reduction of the dislocation. If the current reduction is impossible due to the excessive tension on the muscles of the quadriceps and the displacement of the flexors of the tibia, used band-aid and prescribed muscle relaxants. At the age of 2 years and more, reconstructive surgery is performed.
Valgus curvature, which is hereditary in nature and is observed in newborns quite frequently (in comparison with other deficiencies, knee). During the inspection showed that the visible X-shaped curvature of the lower extremities. The degree of curvature is determined by measuring the distance between the inner ankles in a standing position (infants – reduction of the corrected feet together). X-rays are usually detected violation of the ossification process and the skewness the external femoral condyle. The examination is also prescribed x-rays of the hip joint, as congenital valgus bending of the tibia always in combination with valgus deformity of the femoral head. In adults, usually detected coxarthrosis, and arthrosis in the knee.
In nerezko expressed pathology is assigned to the wearing of orthopedic shoes, a special set of physical therapy and massage. In the case of severe irregularities, the treatment is surgery only. The osteotomy of the bone, is responsible for the curvature (usually femoral). Surgery is indicated in all age groups, even in older patients and, since the restoration of the physiological position of the limb to prevent further development of osteoarthritis.
Varus deformity of the (O-shaped legs) also refers to the fairly common abnormalities, although less frequent than valgus curvature of. As in the previous case, there is a genetic predisposition. Note that with age also small On the form of the deformation can cause the progressive deforming arthrosis with the further formation of ankylosis and severe contractures, so the treatment should be implemented, even if not too pronounced pathology.
During the inspection showed, the distance between the knee with a straight leg and the foot together. On radiographs is determined by the underdevelopment of the internal femoral condyle. Treatment in early childhood is usually conservative: physical therapy, physical therapy and wearing orthopedic shoes, massage. If the deformation, which cannot be resolved with a conservative at the age of 5-6 years performed surgery – osteotomy of the tibia, sometimes in combination with an oblique osteotomy of the fibula.
A very rare abnormality. There is a combination of contracture in the knee and the characteristic wrinkles of the skin in the popliteal region. It is possible to change the location of nerves on the posterior surface of the limb. If you want to exclude pathology of the joint exercise of radiography, to assess the state of soft tissues is a MRI of the femur and tibia. The patient is sent for consultation to the neurologist. Treatment is the only surgical procedure performed at age 5 years and over.