Document Detail


Is correctional osteotomy crucial in primary varus knees undergoing anterior cruciate ligament reconstruction?
MedLine Citation:
PMID:  20872103     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Sung-Jae Kim; Hong-Kyo Moon; Yong-Min Chun; Woo-Hyuk Chang; Sul-Gee Kim
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-09-25
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-01     Completed Date:  2011-06-07     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1421-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery and the Arthroscopy & Joint Research Institute, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analysis of Variance
Anterior Cruciate Ligament / physiopathology,  radiography,  surgery*
Bone Transplantation* / adverse effects
Chi-Square Distribution
Female
Humans
Joint Instability / etiology
Knee Joint / physiopathology,  radiography,  surgery*
Male
Middle Aged
Osteotomy* / adverse effects
Recovery of Function
Republic of Korea
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
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