A Single-Stage Medial Opening Wedge High Tibial Osteotomy for Varus Alignment Correction With Revision Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction.

Autor: Angachekar D; Orthopaedic Surgery, Paramount Hospital and ICCU, Mumbai, IND., Archik S; Orthopaedics and Trauma, Gleneagles Hospital, Mumbai, IND., Narvekar A; Sports Medicine, P.D. (Parmanand Deepchand) Hinduja National Hospital and Medical Research Centre, Mumbai, IND., Kulkarni A; Orthopaedics and Trauma, Pravara institute of Medical Sciences, Loni, IND., Patel S; Orthopaedics, Dr. KNS (Kailash Narayan Singh) Memorial Institute of Medical Sciences, Barabanki, IND.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2024 Mar 11; Vol. 16 (3), pp. e55992. Date of Electronic Publication: 2024 Mar 11 (Print Publication: 2024).
DOI: 10.7759/cureus.55992
Abstrakt: Anterior cruciate ligament (ACL) injuries are a common clinical entity among people involved in contact sports activities. With the number of primary ACL reconstructions increasing, there has been a proportional increase in the revision of failed ACL reconstruction surgeries. As our understanding of knee kinematics improves over time, there has been evidence that alignment of the lower limb weight-bearing axis also plays an important part in ACL functioning. Medial opening wedge high tibial osteotomy (MOWHTO) is one such procedure that has been used extensively worldwide to correct the varus lower limb alignment. This procedure is usually reserved for young active patients with varus lower limb weight-bearing alignment. The technical dilemma for the surgeon arises when there is a need to revise a failed ACL reconstruction while at the same time correcting the axis malalignment. The general dictum says that alignment correction is done first followed by ligament reconstruction in a dual-stage procedure. However, single-stage surgery is possible in certain indications. In this case report, we present the case of a 31-year-old male involved in recreational sports who sustained a repeat ACL tear five years post the index surgery. He also had a significant varus alignment of the lower limb weight-bearing axis which was considered to be one of the causes of index surgery failure. In this report, we would like to highlight the problems we encountered in a single-stage procedure and certain surgical facets of a single-stage alignment surgery with arthroscopic revision ACL reconstruction.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Angachekar et al.)
Databáze: MEDLINE