Either of the operations herein described is recommended when a bone deformity, consisting of a depression of the anterior articulating surface of the tibia, is not a major factor causing genu recurvatum. In this case, the operation of Brett to elevate the tibial plateau or the osteotomy of Campbell or Irwin would be required. It would seem, however, that these osteoplastic operations would not correct the lateral instability which so frequently accompanies genu recurvatum; nor will a check-ligament type of operation ensure lateral stability unless the lateral as well as the posterior structures are reinforced. The original operation to reconstruct collateral ligaments to a more posterior position on the condyles of the femur meets this requirement, and is the operation of choice when lateral instability as well as genu recurvatum is present. When there is no lateral instability of importance, the alternative operation of reinforcing the posterior structures alone is sufficient, and probably more adaptable.