Genu recurvatum

Causes

The following factors may be involved in causing this deformity:

• Inherent laxity of the knee ligaments
• Weakness of biceps femoris muscle
• Instability of the knee joint due to ligaments and joint capsule injuries
• Inappropriate alignment of the tibia and femur
• Malunion of the bones around the knee
• Weakness in the hip extensor muscles
• Gastrocnemius muscle weakness (in standing position)
• Upper motor neuron lesion (for example, hemiplegia as the result of a cerebrovascular accident)
• Lower motor neuron lesion (for example, in post-polio syndrome)
• Deficit in joint proprioception
• Lower limb length discrepancy
• Congenital genu recurvatum
• Cerebral palsy
• Muscular dystrophy
• Limited dorsiflexion (plantar flexion contracture)
• Popliteus muscle weakness
• Connective tissue disorders. In these disorders, there are excessive joint mobility (joint hypermobility) problems. These disorders include:
  • Marfan syndrome
  • Loeys–Dietz syndrome
  • Ehlers–Danlos syndrome
  • Benign hypermobile joint syndrome
  • Osteogenesis imperfecta disease

Pathophysiology

The most important factors of knee stability include:

• Ligaments of the knee: The knee joint is stabilized by four main ligaments:
  • Anterior cruciate ligament (ACL). The ACL has an important role in stabilization of knee extension movement by preventing the knee from hyperextending.
  • Posterior cruciate ligament (PCL)
  • Medial collateral ligament (MCL)
  • Lateral collateral ligament (LCL)
• Joint capsule or articular capsule (especially posterior knee capsule)
• Quadriceps femoris muscle
• Appropriate alignment of the femur and tibia (especially in knee extension position )

Treatment

Treatment generally includes the following:

• Sometimes pharmacologic therapy for initial disease treatment
• Physical therapy: physiotherapy will be beneficial in patient with complaint of pain, discomfort.
• Occupational therapy
• Use of appropriate assistive devices such as orthoses
• Surgery

Incidence

This condition is considered to be rare, with about 1 in 100,000 births being affected by the congenital form of genu recurvatum, although it is a common feature in some disorders, such as in joint hypermobility, which affects 1 in 30 people.

References

References

1. Pednaud. J. Tithonu. "The Human Marvels". thehumanmarvels.com. (8 May 2006). link
2. (2009-08-01). "Children's Orthopaedics and Fractures". Springer.
3. (2013-02-07). "Congenital Genu Recurvatum".
4. (18 October 2017). "Ehlers-Danlos syndromes".