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

Authors
 Sung-Jae Kim  ;  Hong-Kyo Moon  ;  Yong-Min Chun  ;  Woo-Hyuk Chang  ;  Sul-Gee Kim 
Citation
 CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, Vol.469(5) : 1421-1426, 2011 
Journal Title
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
ISSN
 0009-921X 
Issue Date
2011
MeSH
Adolescent ; Adult ; Analysis of Variance ; Anterior Cruciate Ligament/diagnostic imaging ; Anterior Cruciate Ligament/physiopathology ; Anterior Cruciate Ligament/surgery* ; Bone Transplantation*/adverse effects ; Chi-Square Distribution ; Female ; Humans ; Joint Instability/etiology ; Knee Joint/diagnostic imaging ; Knee Joint/physiopathology ; Knee Joint/surgery* ; Male ; Middle Aged ; Osteotomy*/adverse effects ; Radiography ; Recovery of Function ; Republic of Korea ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Young Adult
Keywords
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; High Tibial Osteotomy ; Tibial Tunnel ; International Knee Documentation Committee
Abstract
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.
Files in This Item:
T201100973.pdf Download
DOI
10.1007/s11999-010-1584-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Jae(김성재)
Kim, Sul Ki(김슬기)
Moon, Hong Kyo(문홍교)
Chang, Woo Hyuk(장우혁)
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92882
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