The clinical Outcome of One-stage High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction. A Current Concept Systematic and Comprehensive Review

Alexander Malahias, Michael and Shahpari, Omid and Kyriaki Kaseta, Maria (2018) The clinical Outcome of One-stage High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction. A Current Concept Systematic and Comprehensive Review. The Archives of Bone and Joint Surgery, 6 (3). pp. 161-168.

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Abstract

 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 and ACL reconstruction is an effective, well-established technique with long-term results in the treatment of varus-angu lated knees with ACL deficiency. Methods: A systematic review was conducted by two independent reviewers by searching the MEDLINE/PubMed and the Cochrane Database of Systematic Reviews. These databases were queried with the term â��combined high tibial osteotomy anterior cruciate ligament reconstructionâ�� and â��simultaneous high tibial osteotomy anterior cruciate ligament reconstructionâ��. Results: From the initial 41 studies we finally chose and assessed 6 studies were eligible according to our inclusion-exclusion criteria. The vast majority of the patients were treated with hamstrings autograft (85.6 of the patients), whereas a small minority had a patellar Bone-to-Bone autograft (12.8 of the patients) and 3 patients received a patellar allograft. High tibial open wedge osteotomy was performed in 116 patients (57.4) and closed wedge in 86 patients (42.6). The mean pre-operative angle of the patients included in our review was 6.6º varus, while the mean final post-operative angle was found to be 1.3º valgus. All 6 studies illustrated improved post-operative IKDC with the use of one-stage HTO and ACLR, whereas the reoperation rate was very low. Conclusion: Despite the lack of high quality studies, it seems that one-stage HTO and ACLR is a safe and effective procedure for treatment of patients suffering from symptomatic varus osteoarthritis in combination with anterior knee instability.    Level of evidence: II Â

Item Type: Article
Subjects: WE Musculoskeletal system
WO Surgery
Divisions: Journals > Archives of Bone & Joint Surgery
Depositing User: abjs abjs
Date Deposited: 03 Jul 2018 11:51
Last Modified: 03 Jul 2018 11:51
URI: http://eprints.mums.ac.ir/id/eprint/10024

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