Osteotomy for recurvatum instability
To describe a simple effective technique of opening wedge tibial osteotomy for the treatment of recurvatum (hyperextension) instability of the knee. Recurvatum instability of the knee occurs in patients with pathological hyperextension. There are three patterns of recurvatum instability:
1. Acquired bony deformity of the proximal tibia (growth plate arrest or fracture malunion)
2. Pathological laxity of the posterior capsule of the knee. This may occur without damage to the cruciate ligaments.
3. A combination of bony and soft tissue pathology
All three patterns are best treated by an opening wedge tibial osteotomy at the level of the tibial tubercle. A simple surgical technique is described that does not require detachment of the tibial tubercle. The necessary degree of correction is easily assessed clinically during surgery. The technique has been used with success in 8 patients. The Puddu tooth plate provides ideal fixation. Iliac crest cortico-cancellous wedge hone grafts have been used in all cases.
Unisports Centre for Sports Medicine, Eastwood Orthopaedic Clinic, Auckland.
Copyright British Editorial Society of Bone & Joint Surgery 2003
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