Knee joint instability in conditions of congenital malformations of the lower extremities

Authors

  • Sergij Khmyzov Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-6725-0915
  • Yevgen Yakushkin Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-8291-6538
  • Yelizaveta Katsalap Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872021180-85

Keywords:

Children, knee joint instability, surgical treatment, congenital malformations, lower extremities

Abstract

It is impossible to find out the number of patients with knee joint instability (KJI) in case of congenital malformations of the lower extremities (CMLE). Children, adolescents and young people usually adapt well to this abnormality, so they rarely present with symptoms of instability, even with positive tests. The main reasons for the manifestation of KJI in CMLE are inadequate loading, injuries of the lower extremity and surgical correction. Objective. Based on the assessment of the scientific literature to define the KJI terminology, to identify the main causes of its development and clinical manifestations in conditions of CMLE, to identify trends in the treatment tactics. Methods. More than 500 articles from international libraries PubMed, NCBI, Google Scholar, Medscape, MedlinePlus were searched and analyzed. Taken into account the rarity of the abnormality and the small amount of research in recent years, the depth of the search was 25 years. Results. KJI in children with CMLE may be a consequence of congenital structural features of the lower extremity (isolated malformation in the form of agenesis of the cruciate ligaments or inferiority of the ligament of the knee joint in complex abnormality) and complication of surgical correction of longitudinal defects of the extremities. As the abnormality is not well studied, the tactics for such patients still remain the topic of discussion. The expediency of surgical stabilization of the knee joint has not been conclusively proven due to the fact that in the case of its anomalies certain adaptive mechanisms are formed, which on the one hand are not appropriate to violate, and on the other hand, the current level of medicine allows to promote patients’ functional capabilities, inducing KJI progressing. Conclusions. Children with CMLE adapt well to the concomitant KJI, so in everyday life and prior to surgical correction of CMLE, it does not bother patients. Particular attention should be paid to the stability of the knee joint both before and during prolongation and correction of deformity. The variability and severity of CMLE determines the implementation of multi-stage surgical treatment and surgical stabilization of the knee joint to improve extremity function may be one of them. Key words. Children, knee joint instability, congenital malformations, lower extremities, surgical treatment.

Author Biography

Sergij Khmyzov, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Traumatology and Orthopaedics

References

  1. Indelicato, P. A. (1995). Isolated medial collateral ligament injuries in the knee. Journal of the American Academy of Orthopaedic Surgeons, 3(1), 9-14. https://doi.org/10.5435/00124635-199501000-00002
  2. Knee trauma: Cruciate ligament dysplasia associated with fibular hemimelia (2003:7b). (2003). European Radiology, 13(10), 2402-2404. https://doi.org/10.1007/s00330-003-1892-x
  3. De Ponti, A., Sansone, V., & Da Gama Malchèr, M. (2001). Bilateral absence of the anterior cruciate ligament. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 17(6), 1-4. https://doi.org/10.1053/jars.2001.22411
  4. Manner, H. M., Radler, C., Ganger, R., & Grill, F. (2006). Dysplasia of the cruciate ligaments. The Journal of Bone and Joint Surgery-American Volume, 88(1), 130-137. https://doi.org/10.2106/00004623-200601000-00016
  5. Manner, H. M., Radler, C., Ganger, R., & Grill, F. (2006). Knee deformity in congenital longitudinal deficiencies of the lower extremity. Clinical Orthopaedics and Related Research, 448, 185-192. https://doi.org/10.1097/01.blo.0000218733.38753.90
  6. Fatkullin, N.V., & Zhigaev, G. F. (2006). Modern approaches to surgical treatment of injuries of the cruciate ligaments of the knee joint (literature review). Acta Biomedica Scientifica, 6, 226–228. [in Russian]
  7. Logerstedt, D. S., Scalzitti, D., Risberg, M. A., Engebretsen, L., Webster, K. E., Feller, J., Snyder-Mackler, L., Axe, M. J., & McDonough, C. M. (2017). Knee stability and movement coordination impairments: Knee ligament sprain revision 2017. Journal of Orthopaedic & Sports Physical Therapy, 47(11), A1-A47. https://doi.org/10.2519/jospt.2017.0303
  8. Golka, G. G., Buryanov, O. A., & Klimovitsky, V. G. (2013). Traumatology and orthopedics: a textbook for students. Higher honey. Textbook institutions. Vinnytsia: New book. [in Ukrainian]
  9. Mindler, G. T., Radler, C., & Ganger, R. (2016). The unstable knee in congenital limb deficiency. Journal of Children's Orthopaedics, 10(6), 521-528. https://doi.org/10.1007/s11832-016-0784-y
  10. Changulani, M., Ali, F., Mulgrew, E., Day, J. B., & Zenios, M. (2010). Outcome of limb lengthening in fibular hemimelia and a functional foot. Journal of Children's Orthopaedics, 4(6), 519-524. https://doi.org/10.1007/s11832-010-0291-5
  11. Johnson, K., & Davies, A. M. (2003). Congenital and developmental abnormalities of the knee. Imaging of the Knee, 77-95. https://doi.org/10.1007/978-3-642-55912-9_6
  12. Kwan, K., & Ross, K. (2009). Arthrogryposis and congenital absence of the anterior cruciate ligament: A case report. The Knee, 16(1), 81-82. https://doi.org/10.1016/j.knee.2008.08.004
  13. Heron, D. (2001). Agenesis of cruciate ligaments and menisci causing severe knee dysplasia in TAR syndrome. Journal of Medical Genetics, 38(8), 27e-27. https://doi.org/10.1136/jmg.38.8.e27
  14. Mitsuoka, T., Horibe, S., & Hamada, M. (1998). Osteochondritis dissecans of the medial femoral condyle associated with congenital hypoplasia of the lateral meniscus and anterior cruciate ligament. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 14(6), 630-633. https://doi.org/10.1016/s0749-8063(98)70063-5
  15. Papini Zorli, I., Gallone, D., Guerrasio, S., Berlato, J., & Marinoni, E. (2004). Congenital absence of the anterior cruciate ligament associated wih discoid meniscus. Journal of Orthopaedics and Traumatology, 5(2). https://doi.org/10.1007/s10195-004-0052-7
  16. Malumed, J., Hudanich, R., & Collins, M. (1999). Congenital absence of the anterior and posterior cruciate ligaments in the presence of bilateral absent patellae. The American Journal of Knee Surgery, 12(4), 241–243.
  17. Crawford, D. A., Tompkins, B. J., Baird, G. O., & Caskey, P. M. (2012). The long-term function of the knee in patients with fibular hemimelia and anterior cruciate ligament deficiency. The Journal of Bone and Joint Surgery. British volume, 94-B(3), 328-333. https://doi.org/10.1302/0301-620x.94b3.27997
  18. Cuervo, M., Albiñana, J., Cebrian, J., & Juarez, C. (1996). Congenital hypoplasia of the fibula. Journal of Pediatric Orthopaedics B, 5(1), 35-41. https://doi.org/10.1097/01202412-199605010-00007
  19. Figueroa, D., Calvo, R., Villalón, I. E., Schmidt-Hebbel, A., Figueroa, F., & Baar, A. (2012). Single time angular deformity correction and treatment of knee instability in congenital fibular hemimelia. A case report. The Knee, 19(4), 504-507. https://doi.org/10.1016/j.knee.2011.07.009
  20. Popkov, A., Dučić, S., Lazović, M., Lascombes, P., & Popkov, D. (2019). Limb lengthening and deformity correction in children with abnormal bone. Injury, 50, S79-S86. https://doi.org/10.1016/j.injury.2019.03.045
  21. Prince, D. E., Herzenberg, J. E., Standard, S. C., & Paley, D. (2015). Lengthening with external fixation is effective in congenital femoral deficiency. Clinical Orthopaedics and Related Research, 473(10), 3261-3271. https://doi.org/10.1007/s11999-015-4461-0
  22. Paley, D., Standard, S. C., & Wiesel, S. W. (2010). Treatment of congenital femoral deficiency. Operative techniques in orthopaedic surgery. Philadelphia : Lippincott Williams & Wilkins
  23. Radler, C., Antonietti, G., Ganger, R., & Grill, F. (2011). Recurrence of axial malalignment after surgical correction in congenital femoral deficiency and fibular hemimelia. International Orthopaedics, 35(11), 1683-1688. https://doi.org/10.1007/s00264-011-1266-y
  24. Roux, M. O., & Carlioz, H. (1999). Clinical examination and investigation of the cruciate ligaments in children with fibular Hemimelia. Journal of Pediatric Orthopaedics, 19(2), 247-251. https://doi.org/10.1097/00004694-199903000-00022
  25. Shabtai, L., Specht, S. C., Standard, S. C., & Herzenberg, J. E. (2014). Internal lengthening device for congenital femoral deficiency and fibular Hemimelia. Clinical Orthopaedics and Related Research, 472(12), 3860-3868. https://doi.org/10.1007/s11999-014-3572-3
  26. Graftiaux, A. G., & Kehr, P. (2017). Buckup Klaus MD, Buckup Johannes MD: Clinical test for the musculoskeletal system examinations signs phenomena (3rd edition). European Journal of Orthopaedic Surgery & Traumatology, 27(6), 861-861. https://doi.org/10.1007/s00590-017-1913-0
  27. Keith, A. (1921). Human embryology and morphology. New York, Longmans. https://doi.org/10.5962/bhl.title.44611
  28. Mérida-Velasco, J. A., Sánchez-Montesinos, I., Espín-Ferra, J., Mérida-Velasco, J. R., Rodríguez-Vázquez, J. F., & Jiménez-Collado, J. (1997). Development of the human knee joint ligaments. The Anatomical Record, 248(2), 259-268. https://doi.org/10.1002/(sici)1097-0185(199706)248:2<259::aid-ar13>3.0.co;2-o
  29. Gardner, E., & O’Rahilly, R. (1968). The early development of the knee joint in staged human embryos. Journal of Anatomy, 102(2), 289–299.
  30. O’Rahilly, R. (1951). The early prenatal development of the human knee joint. Journal of Anatomy, 85(2), 166–170.
  31. Ratajczak, W. (2000). Early development of the cruciate ligaments in staged human embryos. Folia Morphologica, 59(4), 285–290.
  32. Chahla, J., Pascual-Garrido, C., & Rodeo, S. A. (2015). Ligament Reconstruction in Congenital Absence of the Anterior Cruciate Ligament: A Report of Two Cases. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 11(2), 177–181. https://doi.org/10.1007/s11420-015-9448-6.
  33. Giorgi, B. (1956). Morphologic variations of the intercondylar eminence of the knee. Clinical Orthopaedics, 8, 209–217.
  34. Manner, H. M., Huebl, M., Radler, C., Ganger, R., Petje, G., & Grill, F. (2007). Accuracy of complex lower-limb deformity correction with external fixation: A comparison of the Taylor spatial frame with the Ilizarov ring fixator. Journal of Children's Orthopaedics, 1(1), 55-61. https://doi.org/10.1007/s11832-006-0005-1
  35. Solomin, L. N., Paley, D., Shchepkina, E. А., Vilensky, V. A., & Skomoroshko, P. V. (2013). A comparative study of the correction of femoral deformity between the Ilizarov apparatus and Ortho-SUV frame. International Orthopaedics, 38(4), 865-872. https://doi.org/10.1007/s00264-013-2247-0
  36. Baumgart, R., Betz, A., & Schweiberer, L. (1997). A fully Implantable motorized intramedullary nail for limb lengthening and bone transport. Clinical Orthopaedics and Related Research, 343, 135–143. https://doi.org/10.1097/00003086-199710000-00023
  37. Horn, J., Grimsrud, Ø., Dagsgard, A. H., Huhnstock, S., & Steen, H. (2014). Femoral lengthening with a motorized intramedullary nail. Acta Orthopaedica, 86(2), 248-256. https://doi.org/10.3109/17453674.2014.960647
  38. Kirane, Y. M., Fragomen, A. T., & Rozbruch, S. R. (2014). Precision of the PRECICE® internal bone lengthening nail. Clinical Orthopaedics and Related Research, 472(12), 3869-3878. https://doi.org/10.1007/s11999-014-3575-0
  39. Rozbruch, S. R., Birch, J. G., Dahl, M. T., & Herzenberg, J. E. (2014). Motorized intramedullary nail for management of limb-length discrepancy and deformity. Journal of the American Academy of Orthopaedic Surgeons, 22(7), 403-409. https://doi.org/10.5435/jaaos-22-07-403
  40. Rudolph, K. S., Axe, M. J., Buchanan, T. S., Scholz, J. P., & Snyder-Mackler, L. (2001). Dynamic stability in the anterior cruciate ligament deficient knee. Knee Surgery, Sports Traumatology, Arthroscopy, 9(2), 62-71. https://doi.org/10.1007/s001670000166
  41. Rue, C. J., Kilcoyne, C. K., Dickens, C. J., & Kluk, C. M. (2011). Diagnosis and treatment of injuries to the Posterolateral ligament complex. Journal of Knee Surgery, 24(03), 143-150. https://doi.org/10.1055/s-0031-1284726
  42. Williams, G. N., Barrance, P. J., Snyder-Mackler, L., Axe, M. J., & Buchanan, T. S. (2003). Specificity of muscle action after anterior cruciate ligament injury. Journal of Orthopaedic Research, 21(6), 1131-1137. https://doi.org/10.1016/s0736-0266(03)00106-2
  43. Williams, G. N., Chmielewski, T., Rudolph, K. S., Buchanan, T. S., & Snyder-Mackler, L. (2001). Dynamic knee stability: Current theory and implications for clinicians and scientists. Journal of Orthopaedic & Sports Physical Therapy, 31(10), 546-566. https://doi.org/10.2519/jospt.2001.31.10.546
  44. Wojtys, E. M., & Huston, L. J. (1994). Neuromuscular performance in normal and anterior cruciate ligament-deficient lower extremities. The American Journal of Sports Medicine, 22(1), 89-104. https://doi.org/10.1177/036354659402200116
  45. Buchanan, T. S., & Lloyd, D. G. (1997). Muscle activation at the human knee during isometric flexion-extension and Varus-valgus loads. Journal of Orthopaedic Research, 15(1), 11-17. https://doi.org/10.1002/jor.1100150103
  46. Khmyzov, S. A. (1993). Elongation and correction of hip deformities in children and adolescents with compression-distraction devices based on rods. [Unpublished PhD dissertation]. [in Russian]
  47. Khvisyuk, O. M. (2013). Orthopedics and Traumatology. Kharkiv. [in Ukrainian]
  48. Van Meer, B. L., Meuffels, D. E., Vissers, M. M., Bierma-Zeinstra, S. M., Verhaar, J. A., Terwee, C. B., & Reijman, M. (2013). Knee injury and osteoarthritis outcome score or international knee documentation committee subjective knee form: Which questionnaire is most useful to monitor patients with an anterior cruciate ligament rupture in the short term? Arthroscopy: The Journal of Arthroscopic & Related Surgery, 29(4), 701-715. https://doi.org/10.1016/j.arthro.2012.12.015
  49. Rossi, R., Dettoni, F., Bruzzone, M., Cottino, U., D'Elicio, D. G., & Bonasia, D. E. (2011). Clinical examination of the knee: Know your tools for diagnosis of knee injuries. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology, 3(1). https://doi.org/10.1186/1758-2555-3-25
  50. Rossi, R., Bruzzone, M., Dettoni, F., & Margheritini, F. (2010). Clinical examination of the knee. Orthopedic Sports Medicine, Principles and Practice, Milan: Springer
  51. Dohle J., Kumm, D. A., & Braun, M. (2000). The «empty» cruciate ligament notch. Aplasia or trauma afte reffect, 103, 693–695. http://doi.org/10.1007/s001130050604.
  52. Anderson, C. J., Ziegler, C. G., Wijdicks, C. A., Engebretsen, L., & LaPrade, R. F. (2012). Arthroscopically pertinent anatomy of the Anterolateral and Posteromedial bundles of the posterior cruciate ligament. Journal of Bone and Joint Surgery, 94(21), 1936-1945. https://doi.org/10.2106/jbjs.k.01710
  53. Schindler, O. S. (2011). Surgery for anterior cruciate ligament deficiency: A historical perspective. Knee Surgery, Sports Traumatology, Arthroscopy, 20(1), 5-47. https://doi.org/10.1007/s00167-011-1756-x
  54. Bhave, A., Shabtai, L., Ong, P., Standard, S. C., Paley, D., & Herzenberg, J. E. (2015). Custom knee device for knee contractures after internal femoral lengthening. Orthopedics, e567-e572. https://doi.org/10.3928/01477447-20150701-53
  55. Paley, D., Harris, M., Debiparshad, K., & Prince, D. (2014). Limb lengthening by Implantable limb lengthening devices. Techniques in Orthopaedics, 29(2), 72-85. https://doi.org/10.1097/bto.0000000000000072
  56. Blakey, C., Saldanha, K., Broadley, P., & Fernandes, J. (2016). Defining patho-anatomy of the knee in congenital longitudinal lower limb deficiencies. Journal of Limb Lengthening & Reconstruction, 2(1), 48. https://doi.org/10.4103/2455-3719.182576
  57. Balke, M., Mueller-Huebenthal, J., Shafizadeh, S., Liem, D., & Hoeher, J. (2010). Unilateral aplasia of both cruciate ligaments. Journal of Orthopaedic Surgery and Research, 5(1). https://doi.org/10.1186/1749-799x-5-11
  58. Jackson, D. W. (2008). Reconstructive knee surgery. Philadelphia: Lippincot William and Wilkins
  59. Frikha, R., Dahmene, J., & Hamida, R. (2005). Congenital absence of the anterior cruciate ligament: eight cases in the same family. Revue de Chirurgie Orthopedique et Reparatrice de L’appareil Moteur, 91(7), 642–648. http://doi.org/10.1016/s0035-1040(05)84468-x.
  60. Gabos, P. G., Rassi, G. E., & Pahys, J. (2005). Knee reconstruction in syndromes with congenital absence of the anterior cruciate ligament. Journal of Pediatric Orthopaedics, 25(2), 210-214. https://doi.org/10.1097/01.bpo.0000153874.74819.29

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Khmyzov, S. ., Yakushkin, Y. ., & Katsalap, Y. . (2021). Knee joint instability in conditions of congenital malformations of the lower extremities. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 80–85. https://doi.org/10.15674/0030-59872021180-85

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No. 1 (2021)

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DIGESTS AND REVIEWS

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