Ankylosis of a knee joint from Medieval London: Trauma, congenital anomaly or osteoarthritis?

Abstract

ObjectiveTo explore the differential diagnoses of a fused left knee joint and the subsequent impairment. MaterialsAn adult female skeleton from the Medieval cemetery of St Mary Spital (London, England). MethodsWe employed digital radiography and macroscopic observation to record the changes observed throughout the skeleton. We also used the Index of Care to explore the subsequent impairment. ResultsA range of congenital and developmental conditions were identified throughout the axial skeleton, with changes to the spine, pelvis, arms and leg bones reflecting adaptation to the mobility impairment. ConclusionsIn all probability, the left knee reflects a case of congenital ankylosis with a differential diagnosis of subadult trauma. The female’s skeleton had adapted to the impairment. Their risk is likely to have been elevated because of climatic and pandemic events during this period. SignificanceFirst reported case of congenital knee ankylosis. LimitationsThe left knee joint was damaged during excavation. Suggestions for further researchAdditional imaging is advised.