Vol.13juni’06Er zijn meerdere goede resultaten beschreven na geslotenrepositie. 6-8 Behoudens milde instabiliteitsklachtenen milde hyperextensie, worden op lange termijnweinig klachten beschreven.Over de niet-reponeerbare knieluxaties zijn weinig resultatengepubliceerd.Bij patiëntje B hadden wij 2 jaar na een open repositiemet een V-Y-plastiek van de quadricepspees een acceptabelresultaat. Langetermijnresultaten blijven tot opheden onbekend. Over de uiteindelijke stabiliteit van dekniegewrichten valt nu nog geen uitspraak te doen.ABSTRACTCongenital dislocation of the knee is very rare. In such cases thetibia is ventrally dislocated relatively to the femur. Congenitaldislocation of the knee can be a part of a syndromal abnormality.As soon as possible treatment by closed reduction with theflexed knee in a plaster should begin. When successful, furtherclosed reduction by progressive flexion and immobilisation ofthe knee can be performed. Usually in such cases the functionalprognosis is favourable.If however, after several weeks the knee dislocation persists, andreduction under general anaesthesia fails, open reduction shouldbe performed. A V-Y plasty of the quadriceps femoris tendon,release of the iliotibial tract and resection of suprapatellarfibrosis usually lead to a good joint reduction.Onze dank gaat uit naar de kinderen en de ouders, <strong>voor</strong> hetverlenen van toestemming <strong>voor</strong> publicatie van de foto’s.LITERATUUR1. Larsen LJ, Schottstaedt ER, Borst FC. Multiple congenitaldislocations associated with facial anormality. J Pediatr1950; 78:291-8.2. CD Liang, CL Hang. Elongation of the aorta and multiplecardiovascular abnormalities associated with LarsenSyndrome. Pediatric cardiol 2001; 22:245-6.3. RH Sijmons, AJ van Essen, JD Visser, M Iprenburg, GFNelck, ML Vos-Bender, B de Jong. Congenital knee dislocationin a 49, XXXXY boy. J Med Genet 1995; 32:309-11.4. Bensahel H., Dal Monte A, Hjelmsted A et al. Congenitaldislocations of the knee. J Pediatr Orthop 1989; 9:174-7.5. Jacobsen K, Vopalecky F. Congenital dislocation of theknee. J Pediatr Orthop 1987;7:194-200.6. Jih-Yang K, Chun-Hsiung S, Dennis R. Congenital dislocationof the knee. J Pediatr Orthop 1999; 19:252-9.7. Haga N, Nakamura S, Sakaguachi R. CongenitalDislocation of the knee Reduced Spontaneously or withMinimal Treatment. J Pediatr Orthop 1997;17:59-628. Platt JL. Congenital Bilateral Hipand Knee DislocationTreated Without Surgery: 18-Year Follow up. J PediatrOrthop 1982; 2:577-81.9. Jacobson K., Vopalecky F. Congenital dislocation of theknee. Acta Orthop Scandinavica. 1985; 56:1-7.10. Iwaya T, Sakaguchi R, Tsuyama N. The treatment of congenitaldislocation of the knee with the Pavlik harness. IntOrthop 1983; 7:25-30.11. Johnson E, Andell R, Oppenheim W.L: congenital dislocationof the knee. J.Pediatr Orthop 1987; 7:194.12. Katz MP, Grogono JS, Soper KC. The ethiology andtreatment of congenital dislocations of the knee. J Bone andJoint Surg Br 1967; 49:112-20.13. Curtis BH, Fisher RL. Congenital hyperextension withanterior subluxation of the Knee. J Bone and Joint Surg Am1969; 51:255-69.118 ■ N<strong>ED</strong>ERLANDS TIJDSCHRIFT VOOR ORTHOPA<strong>ED</strong>IE
NexGen ®Complete Knee SolutionOne Decade Ahead• Ten years of successful clinical history• Documented Zimmer ® Minimally Invasive Solutions (MIS)clinical application since 1999 1• Six-year market leadership with safe high-flexion designs• Lowest revision risk ratio 2• Clinical feedback system currentlyenrolling more than 50,000patients worldwide 3The NexGen MIS Tibial Component was designed to facilitateminimally invasive surgical approaches while providing the samereliability as the traditional stemmed tibial component. By collaboratingwith surgeons worldwide, Zimmer puts industry-leading, MISspecific procedures, implants, instruments, and education in yourhands, helping you return patients to their desired quality of life.1Luke M. Vaughan, MD, “Total Knee Arthroplasty: A Short(er) Incision Technique”.New Technology and Techniques in Total Joint Arthroplasty. Rancho Mirage, CA, Oct 20002Swedish Knee Arthroplasty Register 20043The European and Asia-Pacific clinical feedback study, enrolling 25,000 patients, is runby an independent institution (University of Dundee, UK) ©2005 Zimmer GmbHZimmer Netherlands B.V.Blaeulaan 60, 3528 AD Utrechtzimmer.nederland@zimmer.comwww.zimmer.com