Abstract

Introduction: Knee dislocations are rare injuries that typically result from high-energy trauma. However, the occurrence of non-traumatic anterior knee dislocations, particularly in the context of severe osteoarthritis (OA), is an extremely novel condition that is under-reported in the literature. This case report emphasizes the importance of early recognition and careful surgical planning for patients presenting with knee dislocation due to degenerative changes. The surgical approach must account for severe posterior tibial plateau wear, ligamentous insufficiency, and mechanical instability. Proper assessment and implant selection are crucial to achieving successful outcomes.

Case Presentation: A 58-year-old female patient with severe bilateral knee osteoarthritis and genu varus de formity developed a non-traumatic anterior knee dislocation due to posterior tibial plateau wear. The patient had a high Body Mass Index (BMI) of 47.5 and significant long-standing knee pain. Her left knee showed re stricted range of motion (0–90 degrees). Radiographs revealed Kellgren and Lawrence grade 4 OA, posterior tibial wear, and non-traumatic anterior dislocation. The decision was made to proceed with left total knee replacement (TKR) using a constrained condylar knee prosthesis with stem extensions, posterior augments, and a central tibial cone to restore stability.

Conclusion: This case highlights a novel condition of non-traumatic anterior knee dislocation in the setting of severe OA, resulting from advanced posterior tibial plateau wear. The condition requires extensive surgical planning, including accurate imaging and careful implant selection. With proper intervention, patients can experience significant improvement in knee function and reduced pain, even in complex cases of degenerative knee instability.

DOI: doi.org/10.63721/26JCTC0132

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