Causes and risk factors
Inability of the flexor muscle to straighten along with the bones is the main causative factor for this condition. Certain other causes can also lead to this condition. This condition can either be caused due to destruction of the joint or it can be associated with conditions where the joint anatomy is normal. This condition is commonly seen in people suffering from osteoarthritis. It occurs as a complication following an injury, certain diseases of the bones, prolonged immobilization, burns, or certain congenital abnormality. Cerebral palsy, arthritis, and juvenile rheumatoid arthritis are some of the common contributing factors.
Clinical presentation:
In most of the cases, bilateral affection is seen. Lack of full extension of the knee is the main symptom seen. The patient walks slowly, difficulty in walking is seen. This results in abnormal gait, bent-knee gait occurs. Pain in knee is complained by the patient. Dull aching pain is felt. Over time, crouched gait and limping occurs. Gradually the patient experiences difficulty in carrying our day-to-day activities like sitting, positioning on bed, chair, etc. Patient presents with reduced popliteal angle with difficulty in initiation of straitening or standing up. There is weakness and fatigue felt in quadriceps and hamstring muscles of the thigh.
Investigations:
The symptoms and the history are taken into consideration. A local examination is carried out. In order to confirm the diagnosis, certain investigations are advised. An X-ray of the affected knee is done. Advanced imaging techniques like MRI and CT scan can also be advised.
Treatment:
The treatment plan depends upon the severity of the complaint. It comprises of surgical and nonsurgical methods. The conservative method of treatment comprises of modification of shoes, use of braces for support, or custom knee devices. Physical therapy is needed. Extensive physiotherapy plan involving joint mobilization, passive range exercises at home or physiotherapy centers are required. If the conservative mode of treatment fails, then surgical method is adopted. It comprises of removal of the bone, shortening of the femoral, hamstring lengthening or soft tissue release.
Other modes of treatment:
Certain yoga exercises or physical exercises under a trained physiotherapist will help to strengthen the muscles and ligaments and improve the flexibility.
Complications:
Due to compensatory mechanisms in walking, hip flexion deformity and lumbar lordosis can result.
When to contact a doctor:
Contact an orthopedic doctor if one experiences any pain, swelling, or discomfort in the ankle joint.
System involved: Musculoskeletal system
Organ involved: Bones, nerves, muscles, ligaments, joints, and knee
