The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Simultaneous High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction in knees with Bony Frontal and/or Sagittal Deformities: Review of the Current Literature

Document Type : In Brief

Authors
E. Carlos RODRIGUEZ-MERCHAN 1
Carlos Kalbakdij-Sanchez 2
Carlos A. Encinas-Ullan 1
Ahmed Labib-Zarad 2
1 Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain
2 Department of Orthopedic Surgery, Al Zahra Private Hospital Dubai, Dubai, UAE
10.22038/abjs.2024.78440.3610
Abstract
Simultaneous anterior cruciate ligament (ACL) reconstruction (ACLR) and valgus high tibial osteotomy (HTO) alleviates pain in 70% of individuals with ACL deficiency and varus femorotibial osteoarthritis, allows for sustainable stabilization of the knee at the 10-year follow-up and a return to sport (RTS) in 33%-80% of cases, but femorotibial osteoarthritis progression occurs in 39% of cases. The complication rate ranges from 0% to 23.5% (6.5% revision valgus HTO, 17.5% ACL graft failure, 7.7% venous thrombosis). Simultaneous ACLR and HTO leads to satisfactory results in patients with ACL deficiency and varus femorotibial osteoarthritis associated with a high posterior tibial slope (PTS) and appears to have a protective effect on further ruptures in the reconstructed ACL. The younger the patient and the more sporting demands he/she poses, the more we should be inclined to perform a combined intervention (ACLR and valgus HTO).
        Level of evidence: III
Keywords
Combined chronic ACL deficiency and varus osteoarthritis
Results
Simultaneous valgus high tibial osteotomy and ACL reconstruction
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 8
August 2024
Pages 603-607

  • Receive Date 02 March 2024
  • Revise Date 18 May 2024
  • Accept Date 19 May 2024