Progressive Late-Onset Genu Recurvatum Post-Total Knee Arthroplasty: Insights from a Spinal Stenosis-Related Case Series

Late-onset recurvatum instability following primary total knee arthroplasty (TKA) is an exceptionally rare complication, typically associated with neurological disorders. This case series delves into the experiences of ۱۰ patients who underwent revision surgery due to this uncommon complication resulting from spinal stenosis. The quadriceps muscle weakness was uniformly graded at ۴/۵ across all patients. Following an initial intervention involving the use of a hinge knee brace locked at ۰ degrees extension, substantial improvement was observed. Subsequent to this encouraging progress, all patients underwent revision surgery employing a Rotating Hinge Knee (RHK) prosthesis. In the mean follow-up period of ۳۳ months, none of the patients exhibited a recurrence of recurvatum, affirming the effectiveness of the RHK prosthesis in addressing late-onset recurvatum instability in this scenario. By presenting these cases and reviewing the literature, this article underscores the significance of thoroughly evaluating the spinal condition in TKA candidates and delves into the diagnostic and management challenges associated with patients involved with concurrent spinal stenosis and knee osteoarthritis.