The knee joint is very stable; it is a major weight-bearing joint in mechanical alignment with the hip and ankle for the locomotor system. The knee may dislocate following severe direct trauma and thus become an orthopaedic emergency. If a dislocated knee is not reduced within two weeks, secondary changes such as arthrofibrosis progressively occur. Poor health services, socio-cultural attitudes towards musculoskeletal injuries, and activities of traditional bonesetters are key reasons why patients often present with old or neglected unreduced knee dislocations.

This research reports two cases seen so far within the forty-year existence of our institution, which is in a suburban region of southern Nigeria. The cases reflect the challenges and outcomes of this rare condition with such a bizarre presentation.

The first is a 24-year-old man from a rural farming community who sustained a closed anterior knee dislocation to his right knee following a motorbike accident two years before presentation. He sought care with several traditional bone setters. During that period, he developed an ulceration over the knee that was complicated by the presence of desiccated bones and purulent discharges, following which, a clinico-radiological diagnosis of old unreduced right anterior knee dislocation with peri-articular osteomyelitis was made. We managed by performing a knee arthrodesis procedure, and the patient returned to his daily activities.