A New Approach for the Management of Knee Hyperextension in Pediatric Cases

Abstract

Background: Knee hyperextension can be a serious and disabling injury in both the athletic and general patient population. The flexible type of knee hyperextension can be controlled by either static or dynamic knee orthosis. An important aspect of patient care in knee hyperextension is the application of proper knee orthosis. Knee orthosis is a nonoperative method for the management of knee hyperextension. It is a challenging task in this new engineering field of orthotic science for the orthotist to design suitable orthosis for knee hyperextension. The modern method of orthotic technology needs changes to benefit patients with knee hyperextension to fulfill the functional need for the user. A knee orthosis should, hypothetically, allow full range of motion, except it limits where there will be orthotic constraints. This knee orthosis is a modified polypropylene knee hyperextension orthosis for nonoperative management of knee hyperextension. Aims and Objective of the Study: The purpose of the design is to provide a nonoperative solution to control knee hyperextension in pediatrics for the prevention of knee structures by changing the line of force. Materials and Methods: It is a custom-made orthosis made of polymer sheet with a hinged knee joint with thigh shell and leg shell placed in the contralateral side and provides a rigid support for the knee without hindering knee flexion with full restriction of knee hyperextension. There will be no suprapatellar protrusion like the one conventional plastic supracondylar knee orthosis. Results: Based on observational gait analysis, molded polypropylene knee hyperextension orthosis provides a stable gait pattern with a minute or no gait deviation from the normal gait parameters (gait parameters varies between different subjects). Conclusions: A technique has been proposed for the management of genu recurvatum. A theoretical and practical justification for the method has been presented, and a thorough analysis is required. The use of modified knee orthosis appears to give protection against the anterior tibial translation, thus preventing hyperextension and gives a better gait with the help of initial flexion angle.