Treatment Of Genu Recurvatum Research Articles

Knee ankle foot orthoses in treatment of genu recurvatum: Evaluation of efficiency, users’ satisfaction and tolerance

The aim of this study is to evaluate the efficiency, users’ satisfaction and tolerance of the Knee Ankle Foot Orthosis (KAFO) in treatment of painful genu recurvatum (PGR). Epidemiologic retrospective monocentric study. Patients having a clinical PGR on stance phase confirmed by a practitioner. The main outcome was the pain before and after having the KAFO evaluated with the numerical verbal scale (NVS) of pain rated on 100 and the simple verbal scale (SVS) of pain. The secondary outcomes were the French version of the Quebec user evaluation of satisfaction with assistive technology (QUEBEC 2.0) and a numerical scale of satisfaction (NSS) rated on 100. Twenty-seven patients but 31 KAFO have been analyzed (4 patients had both KAFO): 25 free knee joints/6 locked knee joints. Before and after having the KAFO, the NVS of pain decreased from a mean of 80/100 to 26.9 ( P ≤ 0.001) and the SVS of pain from “extreme” to “weak” ( P ≤ 0.001). The French version of the QUEBEC 2.0 had a total of 4.04 and the NSS had a mean of 86/100. With this study, it was shown that treating a PGR with a KAFO is efficient on pain whatever the pathology from which the patient is suffering, and the patient satisfaction is good.

Treatment of genu recurvatum in hemiparetic adult patients: A systematic literature review

Introduction and methods We carried out a systematic review of the literature on treatment of genu recurvatum in hemiparetic adult patients by searching the PubMed, Pedro, Trip Database and Science Direct databases. The following keywords were used: (recurvatum or hyperextension or knee) and (hemiplegia or hemiparesis). Results Nine articles met our selection criteria. Four assessed retraining methods (functional electric stimulation or electrogoniometric feedback), two assessed orthopaedic or neurosurgical treatments and three articles focused on orthoses. Discussion and conclusion Even though all the various treatments produced encouraging results, most of the reviewed studies presented methodological limitations. Moreover, none of the selected articles suggested a treatment strategy which takes account of the various aetiologies in genu recurvatum. On the basis of some of the reviewed articles and our own clinical experience, we propose an aetiology-specific treatment strategy for genu recurvatum patients. In a broad patient population, this categorization could form the basis for testing the specificity of each treatment method as a function of the cause of genu recurvatum. This approach could help confirm the clinical indications and identify the most appropriate treatment for each patient.

Treatment of Genu Recurvatum by Proximal Tibial Closing-wedge/Anterior Displacement Osteotomy

An operation is described for correction of the osseous form of genu recurvatum, which is secondary to premature closure of the anterior part of the proximal tibial physis with continued growth of the posterior part. At the Alfred I. duPont Institute 14 patients with 17 involved knees have been treated surgically for osseous genu recurvatum. All patients complained of cosmetic deformity, and nine of the 14 had pain. Etiologic factors included immobilization, trauma, and Osgood-Schlatter disease. The average age at surgery was 15 years six months, and the average follow-up period to date has been 20 months. Surgical procedures include the Irwin osteotomy (6 knees), the proximal opening-wedge osteotomy (2 knees), the distal closing-wedge osteotomy (1 knee), and the closing-wedge/anterior displacement osteotomy (8 knees). In all 17 of the knees in this series symptoms resolved following surgery, and 16 knees were stable at clinical examination. The closing-wedge/anterior displacement osteotomy has the advantages of rapid healing, good correction of the deformity, restoration of the depressed tibial tubercle, fewer complications, and resection of the remaining physis, which prevents recurrence.