J Korean Orthop Assoc.  2008 Jun;43(3):391-395. 10.4055/jkoa.2008.43.3.391.

Severe Genu Recurvatum after a Closing-wedge High Tibial Osteotomy: A Case Report

• Ahn JM
• Suh JT

• KMID: 2186458
• DOI: http://doi.org/10.4055/jkoa.2008.43.3.391

Abstract

Although a closing wedge high tibial osteotomy can decrease the posterior tibial slope, there are no reports of severe genu recurvatum after a closing wedge osteotomy that required corrective surgery. A 54-year-old male with medial compartment osteoarthritis and genu varum was treated with a closing wedge high tibial osteotomy in another hospital, which led to severe recurvatum because of surgical failure. He complained of knee pain and a severe deformity, but of which were corrected by an open wedge corrective osteotomy, a two-wedge bicortical autograft reconstruction, and double plate fixation. Surgeons should pay close attention to both varus deformity correction and changes in the posterior tibial slope during a closing wedge high tibial osteotomy.

Keyword

Genu recurvatum; Closing wedge high tibial osteotomy

MeSH Terms

Congenital Abnormalities
Genu Varum
Humans
Knee
Male
Middle Aged
Osteoarthritis
Osteotomy

Figure

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  Fig. 1 Preoperative radiographs of a 54-year-old male showing genu varum with medial compartment osteoarthritis. The femorotibial angle was varus 5 degree and the tibial posterior slope was 7 degrees.

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  Fig. 2 Three months after the closing wedge osteotomy in another hospital, postoperative radiographs show the correction of genu varum but severe genu recurvatum. The femorotibial angle was valgus 2 degrees and the tibial posterior slope was -15 degrees.

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  Fig. 3 Ten months after the closing wedge osteotomy, radiographs show persistent genu recurvatum and loss of valgus correction. The femorotibial angle was varus 2 degrees and the tibial posterior slope was -14 degrees.

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  Fig. 4 Four months after the corrective osteotomy, radiographs show the correction of genu recurvatum and genu varum. The femorotibial angle was valgus 5 degrees and the tibial posterior slope was 4 degrees.

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  Fig. 5 A standing AP radiograph, 14 months after the corrective osteotomy, shows normal alignment compared to the opposite knee. The femorotibial angle is valgus 3 degrees in the right knee and valgus 4 degrees in the left knee.

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  Fig. 6 Photographs, 14 months after corrective osteotomy, show normal alignment and correction of the genu recurvatum.

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