title: Hereditary bilateral genu recurvatum: Case report of a family.
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.
authors.affiliation: Department of Orthopaedic Surgery, Research School Capri, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands. Electronic address: p.feczko@mumc.nl.
authors.forename: Peter
authors.initials: P
authors.lastname: Feczko
authors.affiliation: Department of Orthopaedic Surgery, Research School Capri, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Emans
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000601:surgery; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010375:Pedigree
keywords: Apophysis tibial tuberosity; Genu recurvatum; Navigation; Total knee arthroplasty