Atraumatische anteriore Kniegelenksluxation bei Pangonarthrose

 

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Zusammenfassung

Die Luxation des Kniegelenks ist eine schwerwiegende Verletzung, die in der Regel nach einem Trauma auftritt. Die spontane Luxation ist dagegen eine Rarität. Wir berichten über eine 68-jährige Patientin, bei der im Rahmen einer elektiv geplanten Knietotalendoprothesen-(KTEP-)Implantation in der präoperativen Diagnostik eine anteriore Luxation des Kniegelenks auffällig war. Die radiologischen und klinischen und insbesondere die intraoperativen Befunden deuten auf eine atraumatische Genese hin. Wir vermuten, dass die Arthrose des Kniegelenks die Luxation herbeigeführt hat. Daher empfehlen wir, auch beim eher „harmlosen“ Krankheitsbild der Arthrose, engmaschige klinische und radiologische Verlaufskontrollen, um mögliche Folgeverletzungen früh zu entdecken und adäquat zu therapieren.

Abstract

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.

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