Bilateral sequential knee dislocation in a patient with connective tissue disorder: Report of an unusual case and lessons learnt

Abstract

Tibiofemoral knee dislocation is a rare but serious limb-threatening injury. Without prompt recognition and management, amputation or long-term functional impairment may result. The authors present a case of bilateral sequential knee dislocation, secondary to low-energy trauma, in a patient with Systemic Lupus Erythematosus and antiphospholipid syndrome. Adequate stability was achieved on both occasions by reconstruction of the postero-lateral corner and MCL. During the first reconstruction, ipsi-lateral autograft, as well as hamstring tendons from the contra-lateral side, were used to strengthen the graft. For the second reconstruction, allografts were used. This case highlights that, a patient with soft-tissue disorder presenting with low-energy knee dislocation may be at risk of further dislocations. Treating surgeons should anticipate these issues and consider the role of allograft in ligamentous repair.

Keywords: Anti-phospholipid syndrome; Bilateral knee dislocation; Knee dislocation; Ligament reconstruction; Systemic Lupus Erythematosus (SLE).

Fig. 1

AP right knee.

Fig. 2

Lateral view of right knee.

Fig. 3

AP left knee.

Fig. 4

Lateral view of left knee.

Fig. 5

CT angiogram.