Mohammad Taghi Karimi, Mostafa Kamali, Ali Tahmasebi, Mohammad Hussein Akbari Aghdam

SUMMARY

Background. Knee joint hyperextension, also known as genu recurvatum, has been reported in hemiplegic subjects, cerebral palsy, poliomyelitis, and other neurological conditions. Although various treatment approaches such as orthoses, physical therapy, and surgery have been used for these patients, clinicians usually prefer to treat it with different types of orthoses. Therefore, the aim of this review was to identify the best orthoses used to manage genu recurvatum.

Methods. An extensive search was conducted in ISI Web of Knowledge, PubMed, Embase, Ebsco, Google Scholar, and Scopus. Keywords such as hyperextension of the knee joint and genu recurvatum were used in combination with brace, orthoses, and assistive devices between 1960 and 2024. The quality of identified papers was assessed using the Black and Down tool.

Results. Fourteen papers were identified, with six focusing on ankle-foot orthosis (AFO), six on knee-ankle-foot orthosis (KAFO), and two on knee orthoses (KO). The quality of the papers ranged from 14 to 20. External validity varied between 1 and 3. Reporting scores ranged from 4 to 9, and internal validity (confounding) scores were between 2 and 6. Internal validity (bias) scores varied from 3 to 4.

Conclusions. While there is not enough evidence on the effectiveness of different orthotic interventions for genu recurvatum, it can be concluded that the selection of orthoses depends on the severity of the disease and the presence of concurrent knee valgus deformity. Both AFO and KAFO are effective orthotic interventions for managing genu recurvatum, depending on the disease’s severity. More studies should be conducted on this topic.

KEY WORDS

Genu recurvatum; Knee joint hyperextension; orthosis; conservative treatment; ankle foot orthosis.