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The posterior aspect of the human right knee. OPL, oblique popliteal ligament; FCL, fibular collateral ligament; PCL, posterior cruciate ligament. Modified and reprin- ted with permission from The Journal of Bone and Joint Surgery .
Source publication
Ligament restraints to terminal knee extension are poorly understood.
(1) As with other motions of the knee, genu recurvatum is limited primarily by a named, identifiable structure. (2) As the largest static structure of the posterior knee, the oblique popliteal ligament is uniquely suited to act as a checkrein to knee hyperextension.
Descriptive l...
Context in source publication
Context 1
... our tertiary referral sports medicine practice, we have seen a subset of patients with symptomatic posttraumatic genu recurvatum. These patients complain of knee hyperextension with normal gait or when stepping into holes or when ambulating on uneven terrain. Symptomatic, nonosseous genu recurvatum as a source of posttraumatic functional morbidity is poorly understood. The nature of the anatomical injury has not been identified, and this lack of anatomical understanding has made therapeutic intervention problematic. Clinically, it has been noted that patients with pain and functional genu recurvatum had damage to posterior knee structures in the absence of other sources of ligamentous injury. 29 While a primary stabilizer against knee hyperextension has not been identified, previous authors have hypothe- sized such a role for many structures of the knee. These structures include the cruciate ligaments, 27,30 the bony anatomy of the distal femoral condyles, 7 the collateral ligaments, 14,22,30 the posterior capsule, 7,19,30 the fabellofibular ligament, 32 the medial and lateral menisci, 16 and the oblique popliteal ligament. 4 To our knowledge, no author to date has performed the biomechanical studies necessary to test these hypotheses. Previous investigators have analyzed the posterior knee with forced hyperextension to assess which structures fail. 1 The posterior capsular structures failed first, followed by the posterolateral structures, and then the posterior cruciate ligament. Only one biomechanical sectioning study has been performed on posterior knee structures. 20 Interpretation of this study’s data is problematic, however, as multiple structures in the posterior knee were sectioned simultaneously. Significantly, hyperextension was not tested, nor was the oblique popliteal ligament specifically mentioned by name. Our purpose was to analyze the static restraint to terminal extension using the sequential sectioning technique on the major structures of the posterior knee, posterolateral knee, and the cruciate ligaments. Our hypothesis was that the oblique popliteal ligament, the largest structure of the posterior knee and one which crosses the posterior joint line, would have a significant role in preventing knee hyperextension. Approval for the study was obtained through the Institu- tional Review Board at the University of Minnesota. Five pilot knees were first tested to establish the study design and determine the cutting order of the posterior knee structures and cruciate ligaments. The experiment detailed here was subsequently performed on an additional 20 paired fresh-frozen knees. Clinically significant hyperextension was estimated using published hyperextension values for anterior cruciate ligament impingement within the intercondylar notch of 6.3 ° 6 3.8 ° . 9 An a priori power analysis was then performed to determine sample size using StatMate Software (GraphPad Software Inc, San Diego, California). With an expected standard deviation of 1 ° and setting the significance level ( a ) at .05, the mini- mum group size was determined to be 5 knees to detect a 2.5 ° change. Preparation, dissection, and sectioning were performed using a standardized protocol. The posterior knee was exposed to the superficial crural fascial layer with all individual posterior knee structures left intact (Figure 1). The neurovascular bundle was removed to improve visualization. Each knee was mounted into the testing apparatus via an intramedullary femoral rod secured into place with polymethylmethacrylate (Figure 2). A second intramedullary rod was cemented into the tibia for application of a static weight and manipulation of the joint during hyperextension and rotation experiments. The Polhemus FASTRAK electromagnetic 3-D tracking system (Polhemus Inc, Colchester, Vermont) was used to monitor the move- ment of the femur and tibia. Angles measured within the coordinate systems were calculated by the software that runs the Polhemus FASTRAK device. The accuracy of alter- nating current electromagnetic tracking devices has previ- ously been reported to be within 0.25 ° and 0.1 mm. 17 Coordinate systems were developed for both the femur and tibia using digitized bony landmarks within the electromagnetic field. The center of rotation of each knee was defined to be the epicondylar axis. The y-axis for the femur was defined as a line through the center of the proximal femoral shaft, measured 18 cm proximal to the joint line, and the centroid of a line connecting the medial and lateral femoral epicondyles. The x-axis was then defined as a line perpendicular to the longitudinal axis. The z-axis was defined as perpendicular to the x-axis with its origin at the centroid of the line between the epicondyles. The coordinate system of the tibia was established in a similar manner using the femoral epicondyles to calculate the tibia’s longitudinal axis. The origin of the tibial coordinate system was then defined as the centroid of a line connecting the medial and lateral aspects of the posterior cruciate ligament facet on the tibia. This allowed measurement of tibial translation with respect to the femur. Ten knees were tested with the oblique popliteal ligament sectioned first (hereafter referred to as group 1). This directly tested our hypothesis. In group 1 (10 knees), the cutting order was as follows: (1) oblique popliteal ligament; (2) fabellofibular ligament; (3) ligament of Wrisberg; (4) anterior cruciate ligament; (5) popliteus tendon, popliteofibular ligament, and fibular collateral ligament together as the posterolateral corner 31 ; and (6) posterior cruciate ligament. The individual anatomical structures were then sectioned under direct visualization; the anterior and posterior cruciate ligaments were sectioned through a mini-open medial parapatellar incision. Posttesting dissections were performed to confirm that all ligaments had been sectioned completely. Two additional experimental groups, groups 2 and 3 (5 knees each), were also established with the objective of more directly testing whether the cruciate ligaments had a primary role in resisting knee hyperextension. The cutting orders for groups 2 and 3 were identical to that of group 1 except for a single change; in group 2, the anterior cruciate ligament was sectioned first, and in group 3, the posterior cruciate ligament was sectioned first. Hyperextension experiments were performed by apply- ing moments of 14 and 27 N Á m to the tibia using loads of 44 and 88 N applied 30.5 cm distal to the joint line. Values were based upon published values of peak hyperextension torques recorded in patients with and without knee hyperextension during gait, suggesting these groups see between 0.13 6 0.06 N Á m/kgm and 0.27 6 0.18 N Á m/kgm, respectively. 11 Measurements of the load applied via a load cell (Inter- face, Scottsdale, Arizona) during evaluation of genu recurvatum to measure heel height difference clinically in 2 patients (24 N Á m) were found to be comparable with our applied hyperextension moments. Statistical analysis of hyperextension experiments was performed using GraphPad InStat Version 5.01 (GraphPad, San Diego, California) and included mean and standard deviation, correlation coefficients, and 1-way analysis of variance with posttest Bonferroni multiple comparisons. Tibial slope was measured on digitized lateral radiographs using a published protocol. 5 Angles were measured 3 times using Photoshop CS3 Extended (Adobe Systems, Mountain View, California) and recorded. The a priori assumption for analysis of tibial slope data was that there would be a negative correlation between the final hyperextension observed and the specimen’s tibial slope as measured on a lateral radiograph. We based this assumption on literature suggesting that a proximal tibial osteotomy to increase a knee’s tibial slope can reduce knee hyperextension. 2,3,18,29 Correlation analysis of the tibial slope data was performed using GraphPad Prism Version 5.01 to calculate the Pearson correlation coefficient and a 2- tailed P value. The average age of the specimens was 57.2 years (range, 22-76). None of the knees had any evidence of previous injury or arthritis. All structures were present in the 20 specimens examined. The effect of sectioning the oblique popliteal ligament was ...
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Citations
... Scatter chart of notch width index between affected and normal knee.2024 Jarolia et al. ...
... It takes its origin posteromedially from the distal tendon of the semimembranosus (SM), this thin, broad fascial band passes superolateral and obliquely towards the posterolateral aspect of the lateral femoral condyle (LFC). From a functional perspective, the OPL is suggested to act as the primary ligamentous restraint to knee hyperextension [4], and provide rotatory stability via a tibial attachment [3]. The OPL takes its origin from the posterior surface of the posteromedial tibial plateau and mixes with the fibers from the SM tendon. ...
Purpose
To study the morphology and the morphometry of the oblique popliteal ligament (OPL).
Methods
Thirty cadaver knees were dissected to study the morphology and morphometry of the OPL. For the measurement of the morphology of the OPL a standard tape and the vernier callipers were used.
Result
Out of 30 specimens 14 were Y shaped, 10 were band shaped, and 6 were Z shaped observed. Total length was measured on both the limbs, on the right side it was 4.5 ± 0.4 cm and on the left side 4.5 ± 0.5 cm was recorded. Width at the medial attachment was also measured on both the limbs, on the right side it was 4.6 ± 0.5 cm and on the left side 4.7 ± 0.5 cm was recorded. And width at the lateral attachment was recorded too, on the right side it was 4 ± 0.3 cm and on the left side it was 4 ± 0.3 cm. Width at the midpoint was recorded as on the right side 3.5 ± 0.2 cm and on the left side 3.5 ± 0.2 cm.
Conclusion
The OPL is a thick ligament that arises as an extension of the semimembranosus, and it exists in various morphology which includes band, Y, Z, complex shapes.
... The oblique popliteal ligament plays pivotal role in the stabilisation of the knee during terminal extension and prevents hyperextension of the knee. It has been implicated in the posttraumatic genu recurvatum (9). ...
... Hyperextension affects walking, especially on uneven surfaces (11). Morgan et al (2010) performed a study exploring the biomechanics of the knee joint, in which they sectioned the structures on the posterior aspect of the knee joint one by one, and they found that the maximum degree of hyperextension occurred when the OPL was cut (9). The OPL serves as the main structure that prevents genu recurvatum. ...
... Hyperextension affects walking, especially on uneven surfaces (11). Morgan et al (2010) performed a study exploring the biomechanics of the knee joint, in which they sectioned the structures on the posterior aspect of the knee joint one by one, and they found that the maximum degree of hyperextension occurred when the OPL was cut (9). The OPL serves as the main structure that prevents genu recurvatum. ...
Introduction: The oblique popliteal ligament (OPL), chief posterior support of the knee, is an extension of the semimembranosus (SM) tendon and runs superolaterally to the lateral femoral condyle. Due to variations and immense functional value of the OPL, the present study was undertaken to explore the OPL morphology and morphometry. Materials and methods:Thirty cadaveric lower limbs were dissected to observe the OPL in the floor of the popliteal fossa, and its general shape, number of bands and extensions were noted. The morphometry was done using digital callipers in which the length of the upper and lower margins as well as the width of the OPL at the medial and lateral attachments were measured. The width of bands and extensions were also recorded. The mean and standard deviation (SD) of all parameters have been also calculated. Results:The morphological types of the OPL were categorized into four types, which were found in 40%, 50%, 6.6% and 3.3% of specimens, respectively. Types 1 and 2 OPL were band like. Type 1 showed an accessory upper band and type 2, a broad medial attachment. Type 3 was cord like, whereas type 4 was fan like and showed two upper bands. The mean length (upper), length (lower), width of the SM tendon expansion, width at attachment to the medial femoral condyle and width at the lateral attachment were 33.4 mm, 38.41 mm, 8.58 mm, 12.46 mm and 21.42 mm, respectively. Conclusion:The different morphological types of OPL may produce minor alterations in the stability of the knee, especially in trauma. The anatomical knowledge of OPL and its extensions is mandatory for knee surgery in all patients to avoid postoperative complications.
... However, other investigations have noted contributions from additional structures in preventing knee hyperextension, namely, the popliteus tendon (PLT) and popliteofibular ligament (PFL), 19 while potential contributions from the MCL have not been evaluated. The purpose of this investigation was to assess how sequential sectioning of the static stabilizing structures of the knee (ACL, FCL, PLT, PFL, and MCL) influences heel-height measurements in a cadaveric model when comparing groups undergoing initial transection of the ACL versus FCL, along with an assessment of posterior tibial slope. ...
... No significant differences in heel-height measurements were appreciated, regardless of the initial ligament transected (ACL vs FCL), for all sectioned states. Morgan et al 19 similarly evaluated the contribution of multiple ligaments (oblique popliteal ligament, fabellofibular ligament, ligament of Wrisberg, ACL, PLC, posterior cruciate ligament [PCL]) in knee hyperextension resistance utilizing 20 freshfrozen human knees grouped based on initial transection of either the oblique popliteal ligament (group 1; n ¼ 10 knees), ACL (group 2; n ¼ 5 knees), or PCL (group 3; n ¼ 5 knees). The authors reported that the increase in knee hyperextension was greatest after sectioning of the oblique popliteal ligament compared to all other structures, which was not sectioned in our investigation. ...
... The authors reported that the increase in knee hyperextension was greatest after sectioning of the oblique popliteal ligament compared to all other structures, which was not sectioned in our investigation. Morgan et al 19 reported that both the ACL and PLC resulted in increases in hyperextension in all groups tested after sectioning. While the authors reported similar contributions of the ACL and PLC to increases in hyperextension, the contributions of the FCL were not reported. ...
Background
Anterior cruciate ligament (ACL) tears are often associated with other ligamentous injuries. The side-to-side difference in heel height can represent a valuable diagnostic tool in the setting of multiligamentous injuries.
Purpose
To assess in a cadaveric model how sequential sectioning of the static stabilizing structures of the knee (ACL, fibular collateral ligament [FCL], popliteus tendon [PLT], popliteofibular ligament [PFL], and medial collateral ligament [MCL]) influences heel-height measurements when comparing groups undergoing initial transection of the ACL versus FCL and to assess posterior tibial slope after sequential sectioning.
Study Design
Controlled laboratory study.
Methods
A total of 16 fresh cadaveric knees were carefully dissected to expose the ACL, FCL, PLT, PFL, and MCL. Each knee was randomized to either the ACL-first or FCL-first group based on the initial structure sectioned. The sectioning order was as follows: (1) ACL or FCL, (2) FCL or ACL, (3) PLT, (4) PFL, and (5) MCL. Heel height was measured with a standardized superiorly directed 12-N·m force applied to the knee while stabilizing the femur; heel height was also measured with a clinician-applied force. The measurements were compared between and within groups for each sectioned state. The correlation between tibial slope and heel-height measurements was analyzed.
Results
There were no significant differences in heel-height measurements between the ACL-first and FCL-first groups ( P = .863). Combined ACL-FCL injuries led to a 2.85 ± 0.83–cm increase in heel height compared to the intact state. Significant increases in heel height occurred after all sectioned states, except the PFL sectioned state. Combined ACL–posterolateral corner (PLC) injuries resulted in a 3.72 ± 1.02–cm increase in heel height, and additional sectioning of the MCL resulted in a 4.73 ± 1.35–cm increase compared to the intact state. Tibial slope was not correlated with increases in heel height after each sectioning ( P = .154).
Conclusion
Combined ACL-FCL, ACL-PLC, and ACL-PLC-MCL injuries resulted in increasing mean heel-height measurements (2.85, 3.72, and 4.73 cm, respectively) compared to the intact state. Tibial slope was not found to influence increases in heel height.
Clinical Relevance
The side-to-side difference in heel height may be a clinically relevant examination tool for diagnosing multiligament knee injuries.
... In the distal femur, the coronal plane is an important component of joint congruence, and its malalignment contributes to the development of knee osteoarthritis [2]. The sagittal plane of the knee is crucial for the accurate rotation-sliding mechanism during knee flexion, and its malalignment is associated with anterior and posterior laxity [3] of the knee joint, ligamentous imbalance of the knee [4,5], and patellar subluxation and tilt [6]. Therefore, proper restoration of knee sagittal alignment is of critical value. ...
Background
A coherent measurement approach for sagittal alignment of the distal femur after fracture reduction or distal femur osteotomies is not available. The present study aims to introduce a new method using Blumensaat’s line and tangent lines to the femoral cortexes to determine the sagittal alignment of the distal femur.
Methods
113 patients who had true lateral knee radiographs were included. All of the radiographs were evaluated by one fellowship-trained knee surgeon and one radiologist using the PACS system. The Blumensaat’s line was determined on the true lateral knee radiographs. Then, three long lines were drawn on the distal third of the femoral shaft. The first line is tangent to the anterior cortex of the femur, the second line is along with the anatomical axis of the femur, and the third line is tangent to the posterior cortex of the femur. The angles between Blumensaat’s line and these lines were measured. Intraclass Correlation Coefficient (ICC) was used to measure the strength of inter-and intra-rater agreement.
Results
The mean angle between the Blumensaat’s line and the anatomical axis of the femur was 35.4 ± 3°. The mean angle between the Blumensaat’s line and the line tangent to the anterior femoral cortex and the line tangent to the posterior femoral cortex were 34.5 ± 3° and 35.2 ± 3°, respectively. Excellent inter-and intra-rater reliabilities were observed between the measurements (ICC = 0.96 and ICC = 0.98, respectively). The angle between the Blumensaat’s line and the line tangent to the posterior femoral cortex was significantly higher in participants aged < 38 years (p = 0.049). No other significant association was found between the angles and demographic characteristics of the patients.
Conclusions
The expected mean angles between the Blumensaat’s line and the distal femur were 34.3 to 35.4 degrees. This finding could be useful to determine the normal sagittal alignment of the distal femur.
Level of evidence
II.
... [3][4][5][6] Decreased posterior slope has also been shown to be associated with greater hyperextension of the knee. 6,7 Because of the effect of tibial slope on PTT, patients with PCL reconstruction are at increased risk of postoperative instability. 3 Operative Technique ...
... A systemic review found that anterior slope is the predominant cause of genu recurvatum. 1,7 As posterior tibial slope increases, the resultant force on the PCL also decreases owing to downward forces being directed anteriorly through the tibia. As the posterior tibial slope decreases, forces through the PCL increase and can lead to instability or graft failure in cases of prior PCL reconstruction. ...
... As the posterior tibial slope decreases, forces through the PCL increase and can lead to instability or graft failure in cases of prior PCL reconstruction. 4,7,9 One cohort of 5 osteotomies for the correction of genu recurvatum, with an average preoperative anterior tibial slope of 17 and an average postoperative posterior slope of 0.4 , achieved complete union of the osteotomy by 3 months without complications in all 5 cases. 2 Two of the patients in this cohort with preoperative posterior instability secondary to PCL insufficiency showed improved posterior instability by 1 grade postoperatively, with 1 patient going from grade 3 to grade 2 and another going from grade 2 to grade 1. 2 Another case report of a patient requiring opening wedge anterior tibial osteotomy for genu recurvatum showed uneventful recovery with complete resolution of symptoms and significantly improved subjective scores. 10 Overall, anterior opening wedge anterior proximal osteotomy is a reliable surgical treatment for genu recurvatum, with patients being able to expect correction of knee hyperextension, restoration of a more posterior tibial slope, decreased posterior tibial translation, and increased subjective outcome scores (Table 2). 1 ...
Decreased posterior tibial slope has been associated with increased risk of graft failure and knee instability after posterior cruciate ligament (PCL) reconstruction. Premature physeal arrest at the tibial tubercle is a common cause of osseous genu recurvatum. Surgical management is recommended to correct the tibial slope and prolong the integrity of the PCL graft. This article discusses our preferred treatment using a proximal tibial opening wedge osteotomy for surgical management of posterior knee instability and genu recurvatum secondary to significant anterior tibial slope.
... Practising the triangle pose caused the knee to extend over its baseline by 9.5°on average, and the increased extension has been shown to be significantly correlated to anterior cruciate ligament impingement in uninjured knees [21]. On the contrary, the hyperextension of the knee also contributed to the excessive strain on the oblique popliteal ligament and posterior cruciate ligament [22]. Therefore, even for yoga experts, it is important to avoid hyperextension and associated knee injuries during bending the knees in the triangle pose [9,23]. ...
This study was aimed at exploring the biomechanical characteristics of the lower extremity amongst three typical yoga manoeuvres. A total of thirteen experienced female yoga practitioners were recruited in the current study; they were all certified with the Yoga Alliance. A three-dimensional motion capture system with 10 cameras combined with four synchronised force plates was used to collect kinematics of the lower extremity and ground reactive force whilst the participants performed the crescent lunge pose, warrior II pose, and triangle pose. One-way repeated ANOVA was used in exploring the differences amongst the three yoga movements, and the significance was set to alpha
... Anatomical structures of the posterior aspect of the knee resisted hyperextension and distraction force (gap measurement). Among these structures, the oblique popliteal ligament (OPL) was the most important structure to resist knee hyperextension biomechanically 17 . LaPrade et al. described OPL as one of eight distal attachments of the semimembranosus tendon and the largest structure over the posterior aspect of the knee 2 . ...
This study aimed to determine the factors related to intraoperative extension gap (EG) in patients who underwent posterior-stabilized total knee arthroplasty (TKA). A total of 106 TKAs in 84 patients were retrospectively reviewed. Only patients who underwent the same method of bone resection were included consecutively. Bilateral popliteal angle (BPA) was used as an indicator of hamstring tightness. EG and extension space angle were measured using an offset type tensor. The associations between patient variables and EG were analyzed using multivariable linear regression and Pearson's correlation coefficients. The average EG was 12.9 ± 2.1 mm, and the average extension space angle was 2.8° ± 3.2°. BPA was greater than flexion contracture in most cases (94.3%), and no difference was found in only six cases (5.7%). According to multivariable linear regression analysis which was conducted after modifying the BPA into a categorical variable by 5°, EG was correlated with BPA (p < 0.001). Pearson’s correlation coefficient between EG and BPA was − 0.674 (p < 0.001). No other factors were significantly correlated with intraoperative EG. The present study found that popliteal angle is a different entity from flexion contracture, and that it is a predictable factor for EG in osteoarthritis patients. Smaller BPAs led to larger EG in patients who underwent the same degree of bone resection.
... Most studies included in the current review identified anterior (decreased) tibial slope as the predominant cause of genu recurvatum. In a biomechanical study, Morgan et al 24 reported that knees with decreased tibial slope had an increased amount of hyperextension after ligament injuries of the knee. Thus, it is logical that increasing tibial slope using a PTO was the most common surgical treatment of the chronic injuries because most patients had an anteriorly tilted (decreased) tibial slope in this systematic review. ...
... 9,10,18 A previous biomechanical study showed that the oblique popliteal ligament's midtibial attachment is the most significant restraint to knee hyperextension. 24 As such, it is essential to identify and treat ligamentous causes of symptomatic knee hyperextension in the acute setting when possible. ...
Background
Symptomatic genu recurvatum is a challenging condition to treat. Both osseous and soft tissue treatment options have been reported to address symptomatic genu recurvatum.
Purpose/Hypothesis
The purpose of this article was to review the current literature on surgical treatment options for symptomatic genu recurvatum and to describe the associated clinical outcomes. We hypothesized that anterior opening-wedge proximal tibial osteotomy (PTO) would be the most common surgical technique described in the literature and that this intervention would allow for successful long-term management of symptomatic genu recurvatum.
Study Design
Systematic review; Level of evidence, 4.
Methods
A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with the inclusion criterion of surgical treatment options for symptomatic genu recurvatum. Recurvatum secondary to polio, cerebrovascular accident, or cerebral palsy was excluded from this review.
Results
A total of 311 studies were identified, of which 6 studies with a total of 80 patients met the inclusion criteria. Causes of genu recurvatum included physeal arrest; soft tissue laxity; and complications related to fractures, such as prolonged immobilization and malalignment. Mean follow-up times ranged from 1 to 14.5 years postoperatively. There were 5 studies that described anterior opening-wedge PTO, 2 of which used the Ilizarov distraction technique. All 3 studies that used PTO without the Ilizarov technique reported correction of recurvatum and increased posterior tibial slope; 2 of these studies also included subjective outcomes scores, reporting good or excellent outcomes in 70% (21/30) of patients. Of the studies that used the Ilizarov technique, both reported correction of recurvatum and increased posterior slope from preoperative to postoperative assessments. Both of these studies reported good or excellent subjective outcomes postoperatively in 89.5% (17/19) of patients. Additionally, 1 study successfully corrected recurvatum by performing a retensioning of the posterior capsule to address knee hyperextension, although follow-up was limited to 1 year postoperatively.
Conclusion
Anterior opening-wedge PTO, with or without postoperative external fixation with progressive distraction, was found to be a reliable surgical treatment for symptomatic genu recurvatum. After surgical management with PTO, patients can expect to achieve correction of knee hyperextension, restoration of a more posterior tibial slope, and increased subjective outcome scores.
... Its asymptomatic (i.e. painless) form is most often bilateral, symmetrical, of constitutional "physiological" origin related to capsuloligamentous laxity and in particular to the oblique popliteal ligament that restraint knee hyperextension [9,26,35]. Despite the existence of capsuloligamentous hyperlaxity, the subjects are considered "healthy". ...
Purpose: The main objective of this study is to characterize the lower limb sagittal joint and elevation angles during walking in participants
with asymptomatic genu recurvatum and compare it with control participants without knee deformation. The secondary objective is to study the influence
of walking speed on these kinematic variables.
Methods: The spatio-temporal parameters and kinematics of the lower limb were recorded using an optoelectronic motion capture system in 26 participants (n = 13 with genu recurvatum and n = 13 controls). The participants walked on an instrumented treadmill during five minutes at three different speeds: slow, medium and fast.
Results: Participants with genu recurvatum showed several significant differences with controls: a narrower step width, a greater maximum hip joint extension angle, a greater knee joint extension angle at mid stance, a lower maximum knee joint
extension angle during the swing phase, and a greater ankle joint extension angle at the end of the gait cycle. Participants with genu recurvatum had a greater minimum thigh elevation angle, a greater maximum foot elevation angle, and a change in the orientation of the covariance plane.
Walking speed had a significant effect on nearly all lower limb joint, elevation angle, and covariance plane parameters.
Conclusion: Our findings show that genu recurvatum reshapes lower limb sagittal joint and elevation angles during walking at different speeds but preserves the covariation of elevation angles along a plane during both stance and swing phases and the rotation of this plane with increasing speed.
