Genu Recurvatum – Causes, Symptoms & Treatment
Genu recurvatum is a deformity in which the knee joint hyperextends beyond its normal range. It can be congenital or acquired and is often associated with instability and pain.
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Genu recurvatum is a deformity in which the knee joint hyperextends beyond its normal range. It can be congenital or acquired and is often associated with instability and pain.
What is Genu Recurvatum?
Genu recurvatum (Latin: bent-back knee) is a deformity of the knee joint in which the knee hyperextends backward beyond the normal range of motion during standing or walking. Clinically, it is defined as a hyperextension of more than 5 to 10 degrees. The condition can affect one or both knees and occurs in both children and adults.
Causes
The causes of genu recurvatum are diverse and can be divided into congenital and acquired forms:
- Congenital causes: Genetic connective tissue weakness, intrauterine malpositioning, or congenital joint laxity (hypermobility)
- Neurological conditions: Muscle weakness or paralysis caused by cerebral palsy, poliomyelitis, or myelomeningocele can lead to imbalance of the knee-stabilizing muscles
- Traumatic causes: Ligament injuries (especially to the anterior cruciate ligament), growth plate injuries in childhood, or fractures can contribute to hyperextension
- Degenerative and inflammatory conditions: Osteoarthritis, rheumatoid arthritis, or other joint diseases can compromise knee stability
- Connective tissue disorders: Conditions such as Marfan syndrome or Ehlers-Danlos syndrome are frequently associated with joint hypermobility
Symptoms
The symptoms of genu recurvatum depend on the degree of deformity and the underlying cause. Common symptoms include:
- Visible backward bending of the knee during standing or walking
- Knee pain, especially after prolonged standing or physical activity
- Feeling of instability in the knee joint
- Altered or limping gait pattern
- Muscle weakness or fatigue in the thigh area
- In advanced cases: degenerative changes of the knee joint (gonarthrosis)
Diagnosis
The diagnosis is typically established through a clinical examination. The degree of hyperextension is measured and the stability of the knee ligaments is assessed. The following diagnostic measures may be used:
- Clinical examination: Inspection of the leg axis, goniometry (angle measurement), and gait analysis
- X-ray imaging: Assessment of bony structures and joint space
- MRI (Magnetic Resonance Imaging): Detailed visualization of ligaments, menisci, and cartilage
- Neurological examination: When a neuromuscular cause is suspected
Treatment
Treatment depends on the severity of the deformity and its underlying cause:
Conservative Treatment
- Physiotherapy: Strengthening of the thigh muscles (particularly the quadriceps femoris), improvement of proprioception, and gait training
- Orthoses and braces: Specialized knee orthoses can limit hyperextension and stabilize the joint
- Insoles: Custom orthopedic insoles to correct leg axis alignment
Surgical Treatment
In severe or treatment-resistant cases, surgical intervention may be necessary:
- Ligament reconstruction: Repair or reconstruction of torn or insufficient knee ligaments
- Osteotomy: Corrective bone-cutting procedure to realign the leg axis
- Knee replacement (knee prosthesis): In cases of advanced joint destruction
Prognosis
The prognosis of genu recurvatum depends on the underlying cause and the timing of treatment. With early and consistent therapy, many patients can achieve a significant improvement in stability and become pain-free. If left untreated, there is a risk of progressive joint degeneration.
References
- Moroni A. et al. - Genu Recurvatum: Pathophysiology and Treatment Options. Journal of Orthopaedic Surgery and Research, 2021.
- Staheli L.T. - Fundamentals of Pediatric Orthopedics. Lippincott Williams & Wilkins, 5th Edition, 2016.
- World Health Organization (WHO) - International Classification of Functioning, Disability and Health (ICF). WHO Press, Geneva, 2001.
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