Posterior Capsular Imbrication for Dynamic Genu Valgum

Symptomatic genu recurvatum, defined as knee hyperextension beyond 5° with symptoms of pain or instability, is uncommon and presents a challenging treatment paradigm for orthopaedic surgeons. Treatment options focus on initial nonoperative management with bracing and physical therapy focused on correcting gait abnormalities and strengthening dynamic stabilizers, addressing soft-tissue laxity via posterior capsular tensioning/imbrication, and correcting osseous abnormalities with anterior opening-wedge proximal tibial osteotomies. In cases in which there are minimal bony abnormalities contributing to recurvatum, such as posterior tibial slope, posterior capsular imbrication is indicated. There is a lack of both technical and outcome literature on posterior capsular imbrication; thus, the purpose of this technical note is to describe our technique for performing a modern arthroscopic posterior capsular imbrication for dynamic genu recurvatum.