Peter Feczko1, Pieter Emans2. 1. Department of Orthopaedic Surgery, Research School Capri, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands. Electronic address: p.feczko@mumc.nl. 2. Department of Orthopaedic Surgery, Research School Capri, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands.
Abstract
BACKGROUND: Genu recurvatum is a rare condition in children and adolescents. The origin can be osseous, ligamentous and mixed. METHODS: We describe for the first time a family inclusive two brothers and their mother with hereditary bilateral genu recurvatum of unknown etiology. The possible underlying pathology and treatment are discussed. RESULTS: The underlying pathology of the early closure of the apophysis of the tibial tuberosity remained unclear. The mother was never treated, one of the brothers received a tibial osteotomy as a young adult. Both patients developed end-stage osteoarthritis of both knees which was successfully treated by a bilateral computer-navigated TKA. At seven to eight years after implantation in the older brother (left and right knee, respectively) and three to four years after implantation in the younger brother (right and left knee, respectively), the Visual Analogue Scale (VAS) pain score on a 0 to 100 scale was 0 of both brothers, the EQ-5D health status was 80 (scale of 0 to 100), the satisfaction was 10 (scale of 10) of both brothers. The Knee Injury and Osteoarthritis Outcome Score (KOOS) function of the younger brother of 75 (scale 0 to 100) and of the older brother 100. The KOOS sport of the younger brother was 10 (scale 0 to 100), whereas that of the older brother 85. CONCLUSIONS: Hereditary bilateral genu recurvatum with end-stage osteoarthritis can be successfully treated with computer-navigated TKAs; however, impingement of the patella on the proximal tibia and the position of the tibial keel are of concern.
BACKGROUND: Genu recurvatum is a rare condition in children and adolescents. The origin can be osseous, ligamentous and mixed. METHODS: We describe for the first time a family inclusive two brothers and their mother with hereditary bilateral genu recurvatum of unknown etiology. The possible underlying pathology and treatment are discussed. RESULTS: The underlying pathology of the early closure of the apophysis of the tibial tuberosity remained unclear. The mother was never treated, one of the brothers received a tibial osteotomy as a young adult. Both patients developed end-stage osteoarthritis of both knees which was successfully treated by a bilateral computer-navigated TKA. At seven to eight years after implantation in the older brother (left and right knee, respectively) and three to four years after implantation in the younger brother (right and left knee, respectively), the Visual Analogue Scale (VAS) pain score on a 0 to 100 scale was 0 of both brothers, the EQ-5D health status was 80 (scale of 0 to 100), the satisfaction was 10 (scale of 10) of both brothers. The Knee Injury and Osteoarthritis Outcome Score (KOOS) function of the younger brother of 75 (scale 0 to 100) and of the older brother 100. The KOOS sport of the younger brother was 10 (scale 0 to 100), whereas that of the older brother 85. CONCLUSIONS: Hereditary bilateral genu recurvatum with end-stage osteoarthritis can be successfully treated with computer-navigated TKAs; however, impingement of the patella on the proximal tibia and the position of the tibial keel are of concern.