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All creatures rejoice when the sun rises. It is the spirit of the season with which we can see the world again and feel it for the joy of life. You are a creature, and this is your personal spirit of the season. That is what makes you different and unique. Let it shine for all of your life’s journeys, which is why reflection of light is called a mirror.Clinical exam demonstrating a significant increase in recurvatum, or heel height, in a patient with a posterolateral corner injury of the knee. Increases in heel height associated with genu recurvatum are usually associated with a combined ACL and posterolateral corner injury, especially with either an isolated fibular collateral ligament tear or a fibular collateral ligament tear with a biceps femoris tendon avulsion off the fibular head.
Something that is most important in a patient who presents with genu recurvatum is to combine the clinical exam with above noted radiographs to devise a treatment plan. If a patient does not have any obvious collateral or cruciate ligament injury, then a closely supervised quadriceps strengthening physical therapy program may be indicated. For those patients who have already enrolled in a rehabilitation program and/or have continued problems with knee hyperextension, a brace that attempts to prevent hyperextension of the knee may be indicated. In our hands, we have found that almost all patients who have this problem may respond well for a brief period of time to a brace that limits hyperextension, but in general, still have problems and need to consider surgery.
In most of these patients, because the injury is chronic, a workup will determine that their sagittal plane tibial slope is too flat and an osteotomy is indicated. We have found that a proximal tibial osteotomy which slopes the tibia posteriorly is very effective to address these cases of symptomatic genu recurvatum.The best way to determine the extent of one’s genu recurvatum is simple. Obtaining a ruler and measuring one’s heel height, where the thigh is held against the examining table and one’s great toe is lifted up, and measuring the distance in cm between the bottom of the heel and the table, it is the most effective way to determine the heel height, which correlates to the amount of genu recurvatum. In general, 1 cm heel height correlates to 1 degree of hyperextension, which is denoted by a negative sign for knee motion examination purposes. Therefore, somebody who has “-5” degrees hyperextension would have a 5 cm heel height. (Source:drrobertlaprademd.com)