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.

Combined ACL reconstruction and closing-wedge HTO for varus angulated ACL-deficient knees / Zaffagnini S;Bonanzinga T;Grassi A;Marcheggiani Muccioli GM;Musiani C;Raggi F;Iacono F;Vaccari V;Marcacci M. - In: KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY. - ISSN 0942-2056. - STAMPA. - 21:(2013), pp. 934-941. [10.1007/s00167-013-2400-8]

Combined ACL reconstruction and closing-wedge HTO for varus angulated ACL-deficient knees.

ZAFFAGNINI, STEFANO;BONANZINGA, TOMMASO;MARCHEGGIANI MUCCIOLI, GIULIO MARIA;VACCARI, VITTORIO;MARCACCI, MAURILIO
2013

Abstract

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.
2013
Combined ACL reconstruction and closing-wedge HTO for varus angulated ACL-deficient knees / Zaffagnini S;Bonanzinga T;Grassi A;Marcheggiani Muccioli GM;Musiani C;Raggi F;Iacono F;Vaccari V;Marcacci M. - In: KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY. - ISSN 0942-2056. - STAMPA. - 21:(2013), pp. 934-941. [10.1007/s00167-013-2400-8]
Zaffagnini S;Bonanzinga T;Grassi A;Marcheggiani Muccioli GM;Musiani C;Raggi F;Iacono F;Vaccari V;Marcacci M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/394486
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