Citak M, Ansorge C, Klatte T O, Klauser W, Gehrke T, Kendoff D
Orthopädische Chirurgie, Helios Endo-Klinik Hamburg.
Z Orthop Unfall. 2013 Apr;151(2):138-41. doi: 10.1055/s-0032-1328205. Epub 2013 Apr 25.
Complete knee dislocation is a rare and severe injury and usually follows high-energy trauma. Non-traumatic knee dislocations are exceedingly rare, while severe overweight appears to be the main cause of the knee dislocation. We here report on a spontaneous knee dislocation in a patient with severe osteoarthritis of the left knee. A 68-year-old woman was admitted to our hospital for an elective total knee replacement. One year prior to admission, a planned joint replacement was not performed due to an existing ulcus cruris. After healing of the ulcus cruris, the patient presented with progressive pain and instability of the left knee without any trauma. The clinical examination showed a multidirectional instability of the left knee with a restricted range of motion (ROM) with 0-0-40 degrees for extension and flexion. The performed radiological examination revealed an anterior knee dislocation of the left knee. Intraoperative findings suggest a non-traumatic aetiology. We suspect that osteoarthritis of the left knee has caused the dislocation. Therefore, we recommend, even in usually "harmless" osteoarthritis, close clinical and radiological follow-up examinations to detect and treat possible complications.
完全性膝关节脱位是一种罕见且严重的损伤，通常由高能量创伤引起。非创伤性膝关节脱位极为罕见，而严重超重似乎是膝关节脱位的主要原因。我们在此报告一例左膝重度骨关节炎患者发生的自发性膝关节脱位。一名68岁女性因择期全膝关节置换术入住我院。入院前一年，由于存在小腿溃疡，计划中的关节置换术未进行。小腿溃疡愈合后，患者出现左膝渐进性疼痛和不稳定，无任何外伤史。临床检查显示左膝多向不稳定，活动范围（ROM）受限，伸展和屈曲分别为0-0-40度。所进行的影像学检查显示左膝前脱位。术中发现提示非创伤性病因。我们怀疑左膝骨关节炎导致了脱位。因此，我们建议，即使在通常“无害”的骨关节炎中，也应进行密切的临床和影像学随访检查，以发现并治疗可能的并发症。
