The impaired nomad: A bioarchaeological study on an Early Iron Age case of knee ankylosis from the Jiaerkenjiaga Cemetery, Northwestern China

Abstract

AbstractAbnormality of the knee joint due to diseases or injury would disable the patient's affected leg, lead to difficulty in locomotion and daily life, and in turn makes the patient demand special care from his/her family and community. In this study, we report a case of knee fusion from Jiaerkenjiaga Cemetery, northwestern China, from a male individual who died at the age between 35 and 45 years. Carbon dating of his bone sample shows that he died during 542–391 BCE. The phenomenon was examined through macroscopic observation, digital radiography, and CT scanning. Results demonstrate that the right femur and tibia were fused at the right knee, whilst the patella was fused to the lateral condyle of the right femur. Otherwise, there were no signs of fracture, neoplasm, or other pathological conditions. It was diagnosed as knee ankylosis. It was proposed that this abnormality was likely due to the rupture of the medial patellofemoral ligament and subsequent complication of patella dislocation and septic arthritis. Given the nomadic lifestyle of the Jiaerkenjiaga people, it is speculated that the right patellofemoral ligament of this individual was torn in an accident likely related to horse riding. The well‐remodelled nature of the new bone formation indicates that the injury might have happened years before his death. The impairment would have limited his ability to walk and ride unaided, so someone in his community must have provided him with long‐term care.