Zein Assem Mohamed Noureldin, Mahmoud Hassan Alaa Zenhom, Saleh Elsaid Ahmed Nady
Orthopedic Surgery, Minia University, Kornish El Nile, Minia, Egypt.
Arthrosc Tech. 2022 May 11;11(6):e989-e998. doi: 10.1016/j.eats.2022.02.002. eCollection 2022 Jun.
Genu recurvatum (GR) is defined as knee hyperextension greater than 5°, with the normal physiological accepted limits of up to 10 to 15° of extension. Physiological GR is commonly bilateral, symmetrical, and mostly asymptomatic. Pathologic GR is usually asymmetric, symptomatic, and can be congenital or acquired. Acquired GR can be classified according to the origin of the deformity into pure osseous, soft tissue, and combined types. Symptomatic GR can present with anterior knee pain and/or instability. Surgery is generally indicated in symptomatic (pain, instability), pathologic GR with an associated causative correctible deformity (bony, soft tissue, or a combination of both). Tibial slope-reversing osteotomy is indicated for the osseous or mixed types where there is inverted tibial slope. Varu-correcting osteotomy is indicated in the posttraumatic soft-tissue type (posterior and lateral soft-tissue injury as in knee dislocation), the aim of osteotomy is to protect the reconstructed ligaments. No role for osteotomy in the nontraumatic soft tissue type (gradual stretching of the posterior structures). In this article, we describe a technique to correct a unilateral genu recurvatum deformity with inverted tibial slope, mostly due to Osgood-Schlatter disease. Correction is done by performing an anterior open-wedge osteotomy of the proximal tibia and impaction of 2 wedges of autogenous iliac bone grafts within the osteotomy. The proximal portion of the tibia is cut in the coronal plan and is used as a biologic plate for fixation with no need for additional hardware (e.g., plate or staples) for fixation of the osteotomy.
膝反屈（GR）被定义为膝关节过伸超过5°，而正常生理情况下可接受的伸展限度为10至15°。生理性膝反屈通常是双侧、对称的，且大多无症状。病理性膝反屈通常不对称、有症状，可为先天性或后天性。后天性膝反屈可根据畸形的起源分为单纯骨性、软组织性和混合型。有症状的膝反屈可表现为膝前疼痛和/或不稳定。对于有症状（疼痛、不稳定）的、伴有可纠正的相关病因性畸形（骨性、软组织性或两者皆有）的病理性膝反屈，一般建议进行手术。胫骨斜度反转截骨术适用于存在胫骨斜度倒置的骨性或混合型。内翻矫正截骨术适用于创伤后软组织型（如膝关节脱位时的后外侧软组织损伤），截骨术的目的是保护重建的韧带。截骨术对非创伤性软组织型（后结构逐渐拉伸）无效。在本文中，我们描述了一种矫正单侧膝反屈畸形伴胫骨斜度倒置的技术，主要病因是奥斯古德-施拉特病。通过在胫骨近端进行前路开放楔形截骨术，并在截骨处嵌入2块自体髂骨移植楔块来完成矫正。胫骨近端在冠状面切开，并用作生物钢板进行固定，无需额外的硬件（如钢板或钉）来固定截骨术。
