Combined ACL reconstruction and closing-wedge HTO for varus angulated ACL-deficient knees
| Autor: | Alberto Grassi, Federico Raggi, Stefano Zaffagnini, Vittorio Vaccari, C. Musiani, Francesco Iacono, Tommaso Bonanzinga, Giulio Maria Marcheggiani Muccioli, Maurilio Marcacci |
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| Přispěvatelé: | Zaffagnini S, Bonanzinga T, Grassi A, Marcheggiani Muccioli GM, Musiani C, Raggi F, Iacono F, Vaccari V, Marcacci M |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Joint Instability Male musculoskeletal diseases medicine.medical_specialty high tibial osteotomy Knee Joint Anterior cruciate ligament reconstruction medicine.medical_treatment Anterior cruciate ligament Radiography Tendon Transfer Osteoarthritis Osteotomy Severity of Illness Index Bone Anteversion High tibial osteotomy Tendon transfer medicine Humans Orthopedics and Sports Medicine Anterior Cruciate Ligament Reconstruction Arthrometry Articular Tibia business.industry Middle Aged Osteoarthritis Knee musculoskeletal system medicine.disease Surgery Treatment Outcome surgical procedures operative medicine.anatomical_structure Orthopedic surgery Osteoarthriti Female business human activities ANTERIOR CRUCIATE LIGAMENT Follow-Up Studies |
| Zdroj: | Knee Surgery, Sports Traumatology, Arthroscopy. 21:934-941 |
| ISSN: | 1433-7347 0942-2056 |
| DOI: | 10.1007/s00167-013-2400-8 |
| Popis: | PURPOSE: To report the medium-term clinical and radiographic outcomes of a group of patients who underwent anterior cruciate ligament (ACL) surgery combined with high tibial osteotomy (HTO) for varus-related early medial osteoarthritis (OA) and ACL deficiency knee. METHODS: Thirty-two patients underwent single-bundle over-the-top ACL reconstruction or revision surgery and a concomitant closing-wedge lateral HTO. The mean age at surgery was 40.1 ± 8.1 years. Evaluation at a mean of 6.5 ± 2.7 years of follow-up consisted of subjective and objective IKDC, Tegner Activity Level, EQ-5D, VAS for pain and AP laxity assessment with KT-1000 arthrometer. Limb alignment and OA changes were evaluated on radiographs. RESULTS: All scores significantly improved from pre-operative status to final follow-up. KT-1000 evaluation showed a mean side-to-side difference of 2.2 ± 1.0 mm. Two patients were considered as failures. The mean correction of the limb alignment was 5.6° ± 2.8°. Posterior tibial slope decreased at a mean of 1.2° ± 0.9°. At final follow-up, the mechanical axes crossed the medial-lateral length of tibial plateau at a mean of 56 ± 23 %, with only 1 patient (3 %) presenting severe varus alignment. OA progression was recorded only on the medial compartment (p = 0.0230), with severe medial OA in 22 % of the patients. No patients underwent osteotomy revision, ACL revision, UKA or TKA. CONCLUSIONS: The described technique allowed patients with medial OA, varus alignment and chronic ACL deficiency to restore knee laxity, correct alignment and resume a recreational level of activity at 6.5 years of follow-up. |
| Databáze: | OpenAIRE |
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