The Morel-Lavallée Lesion as a Rare Differential Diagnosis for Recalcitrant Bursitis of the Knee : Case Report and Literature Review

Abstract EN

A 72 year-old-male was referred to our institution with recalcitrant prepatellar bursitis.

The injury was sustained after striking his right knee against a post whilst horse riding 9 months ago.

Previous treatments included repeated aspiration and excision of the bursa with elastic compression bandaging.

A diagnosis of a Morel-Lavallée internal degloving injury was made, and the lesion was satisfactorily managed by an internal quilting procedure to eliminate the potential dead space.

A review of the literature reveals 29 published reports of Morel-Lavallée lesions with sufficient information for inclusion.

These came from 14 separate countries with a total of 204 lesions in 195 patients.

The most common anatomical location was the greater trochanter/hip (36%), followed by the thigh (24%) and the pelvis (19%).

Most were managed surgically with evacuation of the haematoma and necrotic tissue followed by debridement, which was often repeated (36%).

Conservative treatment with percutaneous aspiration and compression bandaging was the next most common treatment (23%).

The knee was the fourth most common region affected (16%), and only 3 other lesions in the literature have been managed with a quilting procedure.