Opening Wedge High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction or Revision
نویسندگان
چکیده
High tibial osteotomy (HTO) is a valid treatment option for young active patients with medial tibiofemoral osteoarthrosis (OA) and varus deformity. Sometimes medial OA is combined with symptomatic anterior cruciate ligament (ACL) deficiency. Although isolated HTO (with possible delayed ACL reconstruction) might be indicated in the older population, young active patients may require combined HTO and ACL reconstruction. In addition, an abnormally increased tibial slope may predispose to ACL reconstruction failure and should be addressed for a successful ACL revision. The combination of HTO and ACL reconstruction produces good results, with resumption of normal daily activities, as well as recreational sports, and does not seem to increase the risk of complications compared with isolated HTO. The purpose of this Technical Note is to describe our indications, planning, and technique for opening wedge HTO fixed with a spacer plate and anatomic soft-tissue (autograft or allograft) ACL reconstruction, with proximal extracortical suspension and distal interference screw fixation.
منابع مشابه
The clinical Outcome of One-stage High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction. A Current Concept Systematic and Comprehensive Review
Background: Patients with an anterior cruciate ligament-deficient varus-angulated knee may need not only an isolated high tibial osteotomy (HTO), but also an additional anterior cruciate ligament reconstruction (ACLR). A number of prospective clinical trials have been published considering the combination of HTO and ACL reconstruction. Our aim was to investigate whether one-stage combined HTO...
متن کاملThe Clinical Outcome of Simultaneous Lateral Closed- Wedge Distal Femoral Osteotomy and Anterior Cruciate Ligament Reconstruction in the ACL-deficient Knees with Symptomatic Femoral Varus Deformity
Background: Nowadays combined high tibial osteotomy and ACL reconstruction is accepted as a safe and effectivesurgery for patients with symptomatic varus osteoarthritis and anterior knee instability; however, the source of varusdeformity is sometimes the femoral bone. No studies have reported concomitant ACL reconstruction and distal femoralosteotomy in ACL-deficient knees wit...
متن کاملAnterior Closing Wedge Tibial Osteotomy for Failed Anterior Cruciate Ligament Reconstruction
Failed reconstruction of the anterior cruciate ligament (ACL) in a young, active patient represents a difficult clinical problem. Numerous factors contribute to failure, including repeat trauma, technical errors, biologic influences, or a combination of causes. Technical errors commonly include femoral and tibial tunnel malposition, inadequate graft fixation, failure to address associated poste...
متن کاملAnterior opening wedge high tibial osteotomy: the effect of increasing posterior tibial slope on ligament strain.
BACKGROUND Although a previous study showed that anterior opening wedge high tibial osteotomy (HTO) for sagittal plane correction induced no increased strain in the anterior cruciate ligament (ACL), we hypothesized that other ligamentous restraints of the knee may be subjected to increased strain. METHODS We mounted 6 cadaveric knees at 15 degrees flexion in a testing apparatus that provided ...
متن کاملOpen wedge osteotomy of the proximal medial tibia for malunited tibial plateau fractures.
PURPOSE To review outcomes of open wedge osteotomy of the proximal medial tibia for malunited tibial plateau fractures. METHODS Seven men (mean age, 36 years) underwent open wedge osteotomy of the proximal medial tibia for instability secondary to malunited tibial plateau fractures of Schatzker types IV (n=3), V (n=1), and VI (n=3). Five patients had been treated conservatively and 2 surgical...
متن کامل