Strategies in Trauma and Limb Reconstruction

Register      Login

VOLUME 16 , ISSUE 2 ( May-August, 2021 ) > List of Articles

Original Article

Correction of Genu Recurvatum Deformity Using a Hexapod Frame: A Case Series and Review of the Literature

Liam Johnson, James McCammon

Keywords : Genu recurvatum, Ilizarov, Osteotomy, Taylor spatial frame

Citation Information : Johnson L, McCammon J. Correction of Genu Recurvatum Deformity Using a Hexapod Frame: A Case Series and Review of the Literature. 2021; 16 (2):116-119.

DOI: 10.5005/jp-journals-10080-1528

License: CC BY-NC-SA 4.0

Published Online: 27-10-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: Genu recurvatum is a rare deformity for which minimal literature exists. Non-operative management typically gives unsatisfactory results. This study aims to evaluate the treatment of genu recurvatum with a hexapod frame. Materials and methods: A single-center retrospective chart review of genu recurvatum cases treated with a hexapod fixator application was performed. Radiographic parameters included the following: leg length discrepancy (LLD), angle of recurvatum, angle of tilt of the tibial plateau, patellar height and anatomic proximal posterior tibial angle (aPPTA). Radiographic and functional results were evaluated. Results: A total of five patients with six limbs corrected with a hexapod frame were found. Aetiology included post-traumatic (2), post-infectious (1) and idiopathic (3). The mean age at application was 13.36 (5.5–18.0) years. The total mean time in the fixator was 225 (160–412) days. The LLD decreased from a mean of 35.6 mm (0.7–50) preoperatively to a mean of 14.8 (1.0–39.3) postoperatively. The average patellar height remained similar 0.97 (0.69–1.2)–0.97 (0.51–1.6). The angle of the tilt of the tibial plateau improved from a preoperative mean of 66° (58.5–73.5°)–92.5° (80–98.5°). The angle of recurvatum improved from a preoperative mean of 26.4° (18.5–31°)–5.0° (0–9°). The aPTTA improved from (102–118°)–85.5° (77–96°). Conclusion: Osteotomy distal to the tibial tuberosity and deformity correction using a hexapod frame allows for multiplanar correction. Throughout treatment, soft tissue management with physical therapy remained key to prevent knee contracture. Clinical significance: A hexapod frame is a safe and accurate technique that allows correction of genu recurvatum along with concomitant deformities with low risk of complications.


HTML PDF Share
  1. Brownstein B, Noyes F, Mangine RE, et al. Anatomy and biomechanics. In: Physical therapy of the knee. New York: Churchill Livingstone; 1988. p. 1–30.
  2. Loudon JK, Goist HL, Loudon KL. Genu recurvatum syndrome. J Orthop Sport Phys Ther 1998;27(5):361–367. DOI: 10.2519/jospt.1998.27.5.361.
  3. Lecuire F, Lerat JL, Bousquet G, et al. Le genu recurvatum et son traitement par ostéotomie tibiale [The treatment of genu recurvatum (author's transl)]. Rev Chir Orthop Reparatrie Appar Mot 1980;66:95–103. PMID: 6451907.
  4. Feczko P, Emans P. Hereditary bilateral genu recurvatum: case report of a family. Knee 2017;24:137–143. DOI: 10.1016/j.knee.2016.09.025.
  5. Moroni A, Pezzuto V, Pompili M, et al. Proximal osteotomy of the tibia for the treatment of genu recurvatum in adults. J Bone Jt Surg 1992;74(4):577–586. PMID: 1583053.
  6. Nathan ST, Parikh SN. Genu recurvatum after tibial tuberosity fracture. Case Rep Orthop 2013;1–5. DOI: 10.1155/2013/952978.
  7. Manohar Babu KV, Fassier F, Rendon JS, et al. Correction of proximal tibial recurvatum using the Ilizarov technique. J Pediatr Orthop 2012;32(1):35–41. DOI: 10.1097/BPO.0b013e31823b15e2.
  8. Choi IH, Chung CY, Cho TJ, et al. Correction of genu recurvatum by the Ilizarov method. J Bone Jt Surg – Ser B 1999;81(5):769–774. DOI: 10.1302/0301-620x.81b5.9589.
  9. Agha RA, Sohrabi C, Mathew G, et al. The PROCESS 2020 Guideline: updating consensus Preferred Reporting Of CasESeries in Surgery (PROCESS) guidelines. Int J Surg 2020;84:231–235. DOI: 10.1016/j.ijsu.2020.11.005.
  10. Paley D. Principles of deformity correction. Heidelberg: Springer-Verlag; 2002.
  11. Segal O. Ilizarov treatment for extreme bilateral genu recurvatum in a pseudoachondroplasia patient: a case report. Acta Orthop Belg 2010;76(1):124. PMID: 20306977.
  12. Van Raaij TM, De Waal Malefijt J. Anterior opening wedge osteotomy of the proximal tibia for anterior knee pain in idiopathic hyperextension knees. Int Orthop 2006;30(4):248–252. DOI: 10.1007/s00264-005-0063-x.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.