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 Ligamentous laxity, or ligament laxity, is a cause of chronic body pain characterized by loose ligaments. When this condition affects joints in the entire body, it is called ''generalized joint hypermobility'', which occurs in about ten percent ...

. 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 Knee pain is pain in or around the knee. The knee joint consists of an articulation between four bones: the femur, tibia, fibula and patella. There are four compartments to the knee. These are the medial and lateral tibiofemoral compartments, the ...

and

knee osteoarthritis Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the w ...

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 The gastrocnemius muscle (plural ''gastrocnemii'') is a superficial two-headed muscle that is in the back part of the lower leg of humans. It runs from its two heads just above the knee to the heel, a three joint muscle (knee, ankle and subtalar ...

weakness (in standing position) *

Upper motor neuron lesion An upper motor neuron lesion (also known as pyramidal insufficiency) Is an injury or abnormality that occurs in the neural pathway above the anterior horn cell of the spinal cord or motor nuclei of the cranial nerves. Conversely, a lower motor n ...

(for example, hemiplegia as the result of a

cerebrovascular accident A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop funct ...

) *

Lower motor neuron lesion A lower motor neuron lesion is a lesion which affects nerve fibers traveling from the lower motor neuron(s) in the anterior horn/ anterior grey column of the spinal cord, or in the motor nuclei of the cranial nerves, to the relevant muscle(s). ...

(for example, in

post-polio syndrome Post-polio syndrome (PPS, poliomyelitis sequelae) is a group of latent symptoms of poliomyelitis (polio), occurring at about a 25–40% rate (latest data greater than 80%). These symptoms are caused by the damaging effects of the viral infection ...

) * Deficit in joint

proprioception Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons ...

Lower limb The human leg, in the general word sense, is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or gluteal region. However, the definition in human anatomy refers only to the section of the lower limb ex ...

length discrepancy * Congenital genu recurvatum *

Cerebral palsy Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sens ...

* Muscular dystrophy * Limited

dorsiflexion Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relativ ...

(

plantar flexion Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relativ ...

contracture) *

Popliteus muscle The popliteus muscle in the leg is used for unlocking the knees when walking, by laterally rotating the femur on the tibia during the closed chain portion of the bipedal gait cycle, gait cycle (one with the foot in contact with the ground). In op ...

weakness * Connective tissue disorders. In these disorders, there are excessive joint mobility (joint hypermobility) problems. These disorders include: ** Marfan syndrome **

Loeys–Dietz syndrome Loeys–Dietz syndrome (LDS) is an autosomal dominant genetic connective tissue disorder. It has features similar to Marfan syndrome and Ehlers–Danlos syndrome. The disorder is marked by aneurysms in the aorta, often in children, and the aorta ...

** Ehlers–Danlos syndrome ** Benign hypermobile joint syndrome **

Osteogenesis imperfecta Osteogenesis imperfecta (; OI), colloquially known as brittle bone disease, is a group of genetic disorders that all result in bones that break easily. The range of symptoms—on the skeleton as well as on the body's other organs—may b ...

disease

Pathophysiology

The most important factors of knee stability include: *

Ligaments A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the: * Peritoneal l ...

of the knee: The knee joint is stabilized by four main ligaments: **

Anterior cruciate ligament The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation ...

(ACL). The ACL has an important role in stabilization of knee extension movement by preventing the knee from hyperextending. **

Posterior cruciate ligament The posterior cruciate ligament (PCL) is a ligament in each knee of humans and various other animals. It works as a counterpart to the anterior cruciate ligament (ACL). It connects the posterior intercondylar area of the tibia to the medial cond ...

(PCL) **

Medial collateral ligament The medial collateral ligament (MCL), or tibial collateral ligament (TCL), is one of the four major ligaments of the knee. It is on the medial (inner) side of the knee joint in humans and other primates. Its primary function is to resist out ...

(MCL) ** Lateral collateral ligament (LCL) *

Joint capsule In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint.Quadriceps femoris muscle The quadriceps femoris muscle (, also called the quadriceps extensor, quadriceps or quads) is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large ...

* Appropriate alignment of the

femur The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with ...

and

tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...

(especially in knee extension position )

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's a common feature in some disorders, such as in joint hypermobility, which affects 1 in 30 people.

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

References

External links