Genu recurvatum

Genu recurvatum
	Ella Harper, a sideshow performer, had genu recurvatum and was billed as The Camel Girl.[1]
Specialty	Medical genetics, rheumatology

Genu recurvatum is a deformity in the knee joint, so that the knee bends backwards. In this deformity, excessive extension occurs in the tibiofemoral joint. Genu recurvatum is also called knee hyperextension and back knee. This deformity is more common in women and people with familial ligamentous laxity.[2] Hyperextension of the knee may be mild, moderate or severe.

The normal range of motion (ROM) of the knee joint is from 0 to 135 degrees in an adult. Full knee extension should be no more than 10 degrees. In genu recurvatum, normal extension is increased. The development of genu recurvatum may lead to knee pain and knee osteoarthritis.

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:

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
Occupational therapy
Use of appropriate assistive devices such as orthoses
Surgical treatment

References

Pednaud, J. Tithonu. "The Human Marvels". thehumanmarvels.com. Retrieved 24 April 2010.
Benson, Michael; Fixsen, John; Macnicol, Malcolm (1 August 2009). Children's Orthopaedics and Fractures. Springer. pp. 495–. ISBN 978-1-84882-610-6. Retrieved 29 July 2011.

External links

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[the_human_marvels-1] Pednaud, J. Tithonu. "The Human Marvels". thehumanmarvels.com. Retrieved 24 April 2010.

[BensonFixsen2009-2] Benson, Michael; Fixsen, John; Macnicol, Malcolm (1 August 2009). Children's Orthopaedics and Fractures. Springer. pp. 495–. ISBN 978-1-84882-610-6. Retrieved 29 July 2011.