Single-Stage Correction of Genu Recurvatum with Dual-Pillar Plating - A Case Report

Genu recurvatum with anterior tibial subluxation is an uncommon but functionally debilitating deformity that can cause progressive pain, instability, and altered gait mechanics in young adults. When conservative management fails, surgical correction becomes necessary to restore alignment, joint biomechanics, and functional capacity. This report describes a reproducible single-stage corrective technique for complex genu recurvatum using biplanar osteotomy, bone graft augmentation, and dual-pillar fixation.

A 19-year-old male presented with a 3-month history of progressive left knee pain, exacerbated by walking and stair climbing. Clinical examination revealed valgus alignment with hyperextension, and radiographs confirmed complex genu recurvatum with anterior tibial subluxation. Laboratory and serological investigations were within normal limits. The patient underwent a single-stage surgical procedure consisting of an 8 mm biplanar tibial tuberosity osteotomy performed distal to the patellar tendon, augmentation with a tricortical iliac crest bone graft, and dual-pillar fixation using medial and lateral plates along with tibial tuberosity screw fixation under C-arm guidance. The post-operative course was uneventful. At 2 months, he demonstrated 0-100° of knee flexion with significant pain reduction. By 5 months, he achieved a full range of motion, complete pain relief, and radiological signs of progressive bone union. At 9 months, he showed stable alignment, full functional recovery, and returned to sports without pain or limitations.

This case highlights the effectiveness of a combined biplanar osteotomy with bone grafting and dual-pillar fixation for treating complex genu recurvatum with anterior tibial subluxation. The technique offers durable correction, maintains patellar height, promotes rapid healing, and supports early return to full functional activities.