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Is correctional osteotomy crucial in primary varus knees undergoing anterior cruciate ligament reconstruction?

 Sung-Jae Kim  ;  Hong-Kyo Moon  ;  Sul-Gee Kim  ;  Woo-Hyuk Chang  ;  Yong-Min Chun 
 Clinical Orthopaedics and Related Research, Vol.469(5) : 1421-1426, 2011 
Journal Title
 Clinical Orthopaedics and Related Research 
Issue Date
BACKGROUND: Valgus high tibial osteotomy (HTO) has been recommended for ligament stability and enhanced function after anterior cruciate ligament (ACL) reconstruction in varus-angulated knees. However, it is not clear whether HTO should be performed in patients undergoing ACL reconstruction who have primary varus knees without medial compartment arthrosis. QUESTIONS/PURPOSES: We therefore asked whether stability and function differed in patients having ACL reconstruction with differing degrees of preoperative alignment. PATIENTS AND METHODS: We retrospectively reviewed 201 patients who had primary, single-bundle ACL reconstructions with primary varus knees based on the preoperative mechanical axis deviation (MAD) on preoperative standing hip-knee-ankle radiographs. Patients were categorized into four groups according to the MAD: Group 1: 0 mm to 4 mm, Group 2: 5 mm to 9 mm, Group 3: 10 mm to 14 mm, and Group 4: greater than 15 mm. A total of 201 patients, 67 in Group 1, 53 in Group 2, 38 in Group 3, and 43 in Group 4, were assessed. Ligament stability was determined with the Lachman test, pivot shift test, and KT 2000™ arthrometer. Functional scores were assessed using the Lysholm score and the International Knee Documentation Committee (IKDC) score. The minimum followup was 24 months (mean, 45 months; range, 24-96 months). RESULTS: We observed no differences in the side-to-side KT 2000™ measurements, Lysholm score, or IKDC functional scores based on the preoperative MAD. CONCLUSIONS: The stability and functional scores after ACL reconstruction were not adversely altered by primary varus alignment. Thus, if there is no medial compartment arthritis or varus thrust, we do not believe a correctional tibial osteotomy is crucial in primary varus knees undergoing ACL reconstruction.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실)
Yonsei Authors
김성재(Kim, Sung Jae) ; 김슬기(Kim, Sul Ki) ; 문홍교(Moon, Hong Kyo) ; 장우혁(Chang, Woo Hyuk) ; 천용민(Chun, Yong Min)
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