Original technique for the treatment of ligament-related genu recurvatum: preliminary results

Abstract

IntroductionFor treatment of ligament-related genu recurvatum the authors developed a technique of retightening the posterior capsule without affecting its integrity. The technique addresses poorly tolerated constitutional genu recurvatum and ligament-related genu recurvatum [16]. This technique is not indicated for genu recurvatum due to osseous deformity, the correction of which obviously involves an osseous intervention [9]. In ligament-related genu recurvatum, in which capsuloligamentous distension typically progressively develops during a chronic phase that can follow severe sprains of the knee (Fig. 1). The authors propose an original technique of tightening the posterior capsule without altering its integrity as would section followed by suturing. Section techniques are frequently subject either to secondary distension or to limitation of knee extension by excessive tightness. Surgical technique Principle of the techniqueThe technique is based upon retightening the posterior capsule and ligament without altering their continuity, in contrast with the technique of section followed by suturing the overlapping edges of the incised capsule. Among its advantages, the present technique does not modify the anatomical position of these insertions, obviating potential dynamic functional pitfalls. The postoperative healing process involves osseous consolidation, which is less haphazard than ligamentous healing. Finally, the simplicity of the intervention and the possibility of secure fixation with osteosynthesis foster relatively early rehabilitation.Abstract The authors report an original technique for treating the genu recurvatum of ligamentous origin. Therapeutic modalities for genu recurvatum are complex and vary with the cause. Moreover, the operations that are designed to correct posterior capsuloligamentous laxity in the knee by exclusively nonosseous procedures frequently lead to secondary distension or to limitation of knee extension by excessive tightness. The authors propose a technique for tightening the posterior capsule without altering its integrity, as would section followed by suturing. The technique, which consists in rolling the bony insertions of the posterior capsule, is described, along with preliminary results in 11 patients.

A comparison of cyclic variations in anterior knee laxity, genu recurvatum, and general joint laxity across the menstrual cycle

“…For example, the origin or cause of GR is thought to be due to a bony deformation of the proximal tibia (e.g. a reduced/reversed posterior tibial slope), excessive capsuloligamentous laxity, or a combination of both 35–37. If the cause is structural in nature, GR may be less sensitive to changes in hormone concentrations (or other potential factors varying cyclically) than AKL and GJL.…”

Joint Laxity Is Related to Lower Extremity Energetics during a Drop Jump Landing

“…When the posterior inferior tibial slope is normal, GR is considered to be of capsuloligamentous origin (25). Conversely, an increase in the anterior-to-posterior tibial slope is thought to contribute to greater AKL because of evidence of greater anterior tibial translation with axial loading (6).…”

Treatment for Symptomatic Genu Recurvatum: A Systematic Review

“…2,7 Additionally, 1 study evaluated patients who underwent retensioning of the posterior soft tissues via advancement and rotation of 2 bone blocks containing the femoral origin of the posterior capsule. 29 All but 1 study reported the mean preoperative degree of recurvatum. Each of the other studies reportedly measured the degree of preoperative and postoperative recurvatum on either standing or supine lateral radiographs.…”