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KMID : 0361620090440050548
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Journal of the Korean Orthopaedic Association
2009 Volume.44 No. 5 p.548 ~ p.555
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One-Staged Open-Wedge High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction
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Song Eun-Kyoo
Park Sang-Jin
Seon Jong-Keun
Jeong Mun-Su
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Abstract
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Purpose: We wanted to evaluate the clinical and radiological results of one-staged open-wedge high tibial osteotomy (HTO) and arthroscopic anterior cruciate ligament (ACL) reconstruction for patients with complete rupture of the ACL and concomitant varus malalignment of the lower limb.
Materials and Methods: Twenty-five patients were prospectively assessed before and 1 year after their simultaneous operation as a single procedure. The clinical assessment included the Lysholm score, the Tegner activity level scale and a physical examination. The radiological data was used to calculate the mechanical axis, the joint space, the tibial slope and the arthrometric stress test. The postoperative complications were also assessed.
Results: The Lysholm knee score and the Tegner activity level scale improved from a mean of 72.1 to 93.8 and from 1.45 to 4.65, respectively (p＜0.05). According to the Lachmann test and the pivot shift test for stability, improvements were made to a grade of 0 or I in most of the patients (p＜0.05) and the STSD with using an arthrometric device significantly improved from 8.8 ㎜ to postoperative 2.6 ㎜ (p＜0.05). The mechanical axis significantly improved from varus 6.1 degrees to valgus 0.3 degrees (p＜0.05). Osteoarthritis of the knee, the posterior tibial slope and the joint space did not show any significant changes (p> 0.05). The severity and rate of the postoperative complications were both low.
Conclusion: One-staged open-wedge HTO and ACL reconstruction produced satisfactory correction of the mechanical axis alignment and, it improved knee function. Further, the procedure had a low complication rate. It is also cost effective due to, reducing the frequency of operation and avoiding overlap of rehabilitation.
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KEYWORD
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Varus Knee, ACL insufficiency, Open-wedge High tibial osteotomy, ACL reconstruction, One-staged
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