Case: We report a patient who was diagnosed with idiopathic genu valgum at the age of 11 years and underwent bilateral distal femur osteotomies. At age 30 years, she presented with pain around her right knee with a varus deformity. Although the corrective osteotomy was at the distal femur, she was noticed to have a bifocal deformity in both femur and tibia. She was managed with single-stage osteotomies at the distal femur and proximal tibia.
Conclusion: This case report highlights the importance of preoperative analysis to identify the site of deformity. In bifocal pathology, a 2-level osteotomy is required to prevent an oblique joint line.
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