Impact of asymptomatic genu recurvatum on patellar mobility in young males
DOI:
https://doi.org/10.17267/2238-2704rpf.2023.e5371Keywords:
Patella, Knee, Hypermobility, JointAbstract
BACKGROUND: Genu recurvatum is one of the most commonly presented lower extremity postural malalignments in individuals. Though genu recurvatum and its impact on impaired knee proprioception, anterior cruciate injuries and posterior soft tissue dysfunctions are reported, its association with patellar mobility is scarcely reported and warrants exploration. OBJECTIVES: To evaluate the medial and lateral patellar mobility differences in adult young males with genu recurvatum and normal knee alignment. METHODS: The ethical approval for this cross-sectional study protocol was obtained and the study was conducted in Research Department of Alva’s College of Physiotherapy and Research Centre, Moodubidire, DK, Karnataka, India. The study participants were recruited through an institutional-based musculoskeletal and sports clinic. The estimated sample size for this study was 174. A total of 87 young males with genu recurvatum and 87 young males with normal knee alignment fulfilling the selection criteria were enrolled in two groups. Participants' knee joint was examined by an assessor and individuals with > 5⁰ knee hyperextension were assigned to genu recurvatum group, and individuals with knee extension < 5⁰ from neutral were assigned to the normal knee alignment group. Further, the patellar glide test was performed to examine the presence of patellar hypermobility in both groups. RESULTS: The mean age of the participants in genu recurvatum and normal knee alignment group was 22.04 + 1.860 and 21.91 + 1.869, respectively. A significant higher proportion (86.2%) of participants with genu recurvatum identified with patellar hypermobility compared to normal knee alignment. Within the genu recurvatum subjects, 66.66& and 19.54% were observed to have medial and lateral patellar hypermobility. The odds for occurrence of patellar hypermobility in genu recurvatum was estimated to be 13.007 (95%, CI, 5.481 – 30.866), respectively. CONCLUSION: The study result suggests that medial patellar hypermobility is more common in individuals with genu recurvatum. Further study investigating on the mechanism contributing towards medial patellar mobility in genu recurvatum populations could validate the present study findings.
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(1) Yazdani S, Alizadeh F, Dizaji E, Mohammadi F. Postural sway changes in genu recurvatum deformity during standing with manipulation of visual and proprioceptive systems. J Bodyw Mov Ther. 2020;24(4):147-51. https://doi.org/10.1016/j.jbmt.2020.06.018
(2) Shagawa M, Maruyama S, Sekine C, Yokota H, Hirabayashi R, Hirata A, et al. Comparison of anterior knee laxity, stiffness, genu recurvatum, and general joint laxity in the late follicular phase and the ovulatory phase of the menstrual cycle. BMC Musculoskelet Disord. 2021;22(1):886. https://doi.org/10.1186/s12891-021-04767-8
(3) Lazaro RM, Souza RB, Luke AC. Patellar mobility and lower limb kinematics during functional activities in individuals with and without patellar tendinopathy. Knee. 2021;30:241-8. https://doi.org/10.1016/j.knee.2021.04.002
(4) Ota S, Nakashima T, Morisaka A, Ida K, Kawamura M. Comparison of patellar mobility in female adults with and without patellofemoral pain. J Orthop Sports Phys Ther. 2008;38(7):396-402. https://doi.org/10.2519/jospt.2008.2585
(5) Loudon JK. Biomechanics and pathomechanics of the patellofemoral joint. Int J Sports Phys Ther. 2016;11(6):820-30. Cited: PMID: 27904787.
(6) Hryvniak D, Magrum E, Wilder R. Patellofemoral Pain Syndrome: An Update. Curr Phys Med Rehabil Rep. 2014;2:16-24. https://doi.org/10.1007/s40141-014-0044-3
(7) Arendt EA, Dejour D. Patella instability: building bridges across the ocean a historic review. Knee Surg Sports Traumatol Arthrosc. 2013;21(2):279-93. https://doi.org/10.1007/s00167-012-2274-1
(8) Dierick F, Schreiber C, Lavallée P, Buisseret F. Asymptomatic Genu Recurvatum reshapes lower limb sagittal joint and elevation angles during gait at different speeds. Knee. 2021;29:457-68. https://doi.org/10.1016/j.knee.2021.02.003
(9) Dean RS, Graden NR, Kahat DH, DePhillipo NN, LaPrade RF. Treatment for Symptomatic Genu Recurvatum: A Systematic Review. Orthop J Sports Med. 2020;8(8):2325967120944113. https://doi.org/10.1177/2325967120944113
(10) Shultz SJ, Nguyen AD, Windley TC, Kulas AS, Botic TL, Beynnon BD. Intratester and intertester reliability of clinical measures of lower extremity anatomic characteristics: implications for multicenter studies. Clin J Sport Med. 2006;16(2):155-61. https://doi.org/10.1097/00042752-200603000-00012
(11) Nomura E, Inoue M, Kobayashi S. Generalized joint laxity and contralateral patellar hypermobility in unilateral recurrent patellar dislocators. Arthroscopy. 2006;22(8):861-5. https://doi.org/10.1016/j.arthro.2006.04.090
(12) Shultz SJ, Carcia CR, Perrin DH. Knee joint laxity affects muscle activation patterns in the healthy knee. J Electromyogr Kinesiol. 2004;14(4):475-83. https://doi.org/10.1016/j.jelekin.2003.11.001
(13) McKeon JMM, Hertel J. Sex differences and representative values for 6 lower extremity alignment measures. J Athl Train. 2009;44(3):249-55. https://doi.org/10.4085/1062-6050-44.3.249
(14) Kawahara K, Sekimoto T, Watanabe S, Yamamoto K, Tajima T, Yamaguchi N, et al. Effect of genu recurvatum on the anterior cruciate ligament-deficient knee during gait. Knee Surg Sports Traumatol Arthrosc. 2012;20(8):1479-87. https://doi.org/10.1007/s00167-011-1701-z
(15) Ahn SH, Kwon OY, Hwang UJ, Jung SH, Kim HA, Kim JH. The association between genu recurvatum angle and the strength of the hip and knee muscles in standing workers. Work. 2020;66(1):173-81. https://doi.org/10.3233/wor-203161
(16) Ota S, Nakashima T, Morisaka A, Ida K, Kawamura M. Comparison of patellar mobility in female adults with and without patellofemoral pain. J Orthop Sports Phy Ther. 2008;38(7):396-402. https://doi.org/10.2519/jospt.2008.2585
(17) Amis AA. Current concepts on anatomy and biomechanics of patellar stability. Sports Med Arthrosc Rev. 2007;15(2):48-56. https://doi.org/10.1097/jsa.0b013e318053eb74
(18) Jaggi A, Lambert SM. Regional complications in joint hypermobility syndrome. In: Hakim AJ, Keer R, Grahame R. Hypermobility, Fibromyalgia and Chronic Pain. Churchill Livingstone; 2010. p. 197-280. https://doi.org/10.1016/B978-0-7020-3005-5.00016-1
(19) Shultz SJ, Dudley WN, Kong Y. Identifying multiplanar knee laxity profiles and associated physical characteristics. J Athl Train. 2012;47(2):159-69. https://doi.org/10.4085/1062-6050-47.2.159
(20) Requier B, Bensoussan L, Mancini J, Delarque A, Viton JM, Kerzoncuf M. Knee-ankle-foot orthoses for treating posterior knee pain resulting from genu recurvatum: Efficiency, patients' tolerance and satisfaction. J Rehabil Med. 2018;50(5):451-56. https://doi.org/10.2340/16501977-2333
(21) Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, White LM. Epidemiology and natural history of acute patellar dislocation. Am J Sports Med. 2004;32(5):1114-21. https://doi.org/10.1177/0363546503260788
(22) Sweitzer BA, Cook C, Steadman JR, Hawkins RJ, Wyland DJ. The inter-rater reliability and diagnostic accuracy of patellar mobility tests in patients with anterior knee pain. Phys Sports Med. 2010;38(3):90-6. https://doi.org/10.3810/psm.2010.10.1813
(23) Larson CM, Bedi A, Dietrich ME, Swaringen JC, Wulf CA, Rowley DM, et al. Generalized hypermobility, knee hyperextension, and outcomes after anterior cruciate ligament reconstruction: prospective, case-control study with mean 6 years follow-up. Arthroscopy. 2017;33(10):1852-8. https://doi.org/10.1016/j.arthro.2017.04.012
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Copyright (c) 2023 Noble Vavachan, Hariharasudhan Ravichandran, Kshama Susheel Shetty, Balamurugan Janakiraman
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
