Traumatic Simultaneous Bilateral Knee Dislocation: A Case Report.

Bilateral knee dislocation is an extremely rare and devastating injury to the knee joint. This injury is a true emergency as concomitant injuries may threaten life and limb. Here, we report the case of a 26-year-old male patient who sustained bilateral knee dislocation due to a high-velocity motor vehicle accident. In this case, the patient suffered a feared complication associated with knee dislocation, popliteal artery disruption with peroneal nerve damage. Abdominal and skeletal injuries were also discovered and treated appropriately by a multidisciplinary team. A staged surgical approach to ligament reconstruction was used without any postoperative complication. Postoperatively, the patient successfully returned to his preoperative activity level.

Pediatric Anterior Cruciate Ligament Reconstruction: A Reason Not to Wait Until Skeletal Maturity.

Anterior cruciate ligament (ACL) tears within the skeletally immature population give rise to controversy regarding the timing of treatment decisions due to the concern of iatrogenic damage to the open physis. Physis disruption from the required intraoperative graft tunnel drilling can lead to growth disturbance, thus ligament reconstruction is not without risk. Nonoperative management carries the risk of future damage to the menisci and cartilage as an ACL-deficient knee can be unstable. This particular case of a skeletally immature 10-year old male demonstrates an initial course of nonoperative treatment which ultimately resulted in previously undiagnosed meniscal damage. Failure of the nonoperative treatment was followed by a successful ACL reconstruction and meniscal repair surgery utilizing a partial physeal sparing technique. The patient successfully returned to his preoperative activity level without any graft disruption, postoperative indications of meniscus pathology, or abnormal growth deformities. This case report adds to the current literature reporting successful and safe ACL reconstructions in a skeletally immature patient.

Management of bilateral osteochondritis dissecans of the trochlea in a skeletally immature patient.

Osteochondritis dissecans (OCD) lesions are injuries that occur more commonly in the skeletally immature population. In most cases, the aetiology is not well understood, but fortunately, many OCD lesions may heal on their own over time, particularly in skeletally immature patients with open physes. Conversely, if the lesion is considered unstable, surgical intervention may be required. This case demonstrates an especially rare presentation of bilateral OCD lesions within the lateral femoral trochlear facet. The lesions became symptomatic approximately 1 year apart without a specific injury. Non-operative treatment was not recommended in either case due to the size and instability of each lesion. The surgical treatment used an augmented microfracture technique. At 12 and 23 months after surgery, both knees remain asymptomatic and the patient has returned to their desired activities.