Below is an image of genu (knee) recurvatum in which the knee has the structural capability to bow backward which can lead to mechanical instability.
Congenital
- Secondary to intra uterine posture
- These are flexible and respond to conservative management
- Gentle manipulation should start at birth
- Tibia is brought posterior to the femur as the knee is flexed
- After manipulation the desired correction may be held with a cast
- Severe cases may be associated with congenital dislocation of the knee
- Is most common with arthrogryposis and myelodysplasia
- Often associated with club feet, CDH, and other congenital anomalies
- Treatment
- Begin nonoperative management as above
- If < 30° flexion at 3 months, needs operative release
Laxity of ligaments
- e.g. in prolonged splinting in hyperextension and neurological problems
Bone injury
- May cause faulty growth or malunion of a fracture
Treatment
- Related to disability and age
- Generalised laxity needs no treatment
- Splinting or muscular strengthening