Flexion Deformity of the Knee
defenition/description[edit | edit source]
A flexion deformity of the knee is the inability to fully straighten the knee. A synonym for it is flexion contracture. Normal active range of motion of the knee is 0° extension and 140° flexion. In people with a flexion deformity one of them or both are reduced. It develops as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title They often requires an extensive rehabilitation. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title In most of the cases flexion deformities occur bilateral.
Epidemiology/etiology[edit | edit source]
Flexion deformities can arise by different causes. Two types of flexion contracture of the knee can be distinguished: that associated with joint destruction and ankylosis and that in which joint anatomy and mobility are preserved.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title They can be caused by a piece of bone or other tissue getting in the way and blocking movement, knee replacement components in the wrong position, scar tissue restricting that cannot further straightening an extreme tightness in the hamstring muscles. Flexion deformities are common complications following trauma, inflammatory conditions, immobilization, burns and congenital deformities. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
A few examples in which flexion contractures of the knee can occur are: burn scars, intra-articular fractures, septic arthritis, juvenile rheumatoid arthritis, cerebral palsy and many others. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Characteristics/clinical presentation[edit | edit source]
Patients with flexion contractures often walk with a bent-knee gait. This provides increasing strain on the quadriceps and increasing strain contact forces in the patellofemoral joint. Walking distance is reduced and increased strain during bent-knee gait may lead to quadriceps weakness and earlier onset of the quadriceps fatigue. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Other symptoms of flexion contractures are anterior knee pain, a progressive crouch gait and limping while walking. Often they will make compensatory movements and a hip flexion deformity can occur accompanied by lumbar lordosis. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Short-term and long-term changes can be distinguished. Early changes are shortening of stride gait, reduced popliteal angle and a flexed position of the knee at the initiation of the stand phase and throughout gait cycle. Changes which appear later are severe contracture of knee and hip and patella alta.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Knee flexion contractures have a lot of functional consequences such as weight-bearing activities and difficulties with bed or chair positioning. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Normal daily activities provide difficulties because they need more energy.
