The knee may be dislocated at birth.
(See also Overview of Congenital Musculoskeletal Anomalies.)
Anterior knee dislocation with hyperextension is rare at birth but requires emergency evaluation to ensure there is no vascular compromise. It may occur with Larsen syndrome, which consists of multiple congenital dislocations (eg, elbows, hips, knees), clubfoot, and characteristic facies (eg, prominent forehead, depressed nasal bridge, wide-spaced eyes), or with arthrogryposis. The dislocation may be related to muscle imbalance (if myelodysplasia or arthrogryposis is present) or intrauterine positioning. Ipsilateral hip dislocation often coexists.
On examination the leg is extended and cannot be flexed more than a few degrees.
Imaging tests, including radiographs, MRI, or CT of the affected area, are often done.
If the infant is otherwise normal, immediate treatment with daily passive flexion movements and splinting in flexion usually results in a functional knee.
