Hyperextension Gait Abnormalities

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It is well appreciated that patients with chronic insufficiency of the lateral and posterolateral structures of the knee may develop a gait abnormality that is characterized by excessive knee hyperextension during the stance phase (initial contact or heel strike, loading response, midstance, and toe-off) of the gait cycle.

The primary lateral and posterolateral structures of the knee joint are the fibular collateral ligament (FCL) and popliteus muscle-tendon-ligament unit (PMTL), including the popliteofibular ligament (PFL) and posterolateral capsule (PLC). These structures function together to resist lateral tibiofemoral compartment opening, posterior subluxation of the lateral tibial plateau with tibial rotation, knee hyperextension, and varus recurvatum.8, 9, 12, 13, 19, 27 Posterolateral injuries are frequently accompanied by a rupture to the anterior cruciate ligament (ACL) and, in some cases, a rupture to the posterior cruciate ligament (PCL).5, 7, 11 In addition, many knees with insufficiency to the posterolateral structures also have varus osseous malalignment.

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