Simultaneous anterior cruciate ligament reconstruction and computer-assisted open-wedge high tibial osteotomy: a report of eight cases.
Eight patients, aged 37-50 years, with chronic anterior cruciate ligament (ACL) deficiency, medial compartment osteoarthritis and varus deformity underwent simultaneous arthroscopic ACL reconstruction and open-wedge high tibial osteotomy controlled by a computer navigation system. Despite preoperative planning, the surgeon may need to choose a different osteotomy site during the procedure, invalidating the previous plans. The intraoperative wire control for osteotomies is not precise. The navigation system can help obtain precise alignment during high tibial osteotomy. The average preoperative mechanical axis was 7.5 of varum (sd±1.17°), the average postoperative axis was 1.2° of valgus (sd±1.04°) (p<0.01), and the average correction of the mechanical axis was 8.7° (sd±0.76°). The site of the osteotomy was 3.9 cm (3.5-4.8 cm, sd±0.35 mm) from the articular line, with an inclination of 27.9° (24-35, sd±4.8). The simultaneous use of these procedures allowed proper correction of the knee axis during the surgery. The surgery can be performed concomitantly with ACL reconstruction.
University of São Paulo, Hospital das Clínicas, Brazil. demange@usp.br
Marco Kawamura
MK
Demange
Gilberto Luis
GL
Camanho
José Ricardo
JR
Pécora
Riccardo Gomes
RG
Gobbi
Luis Eduardo Passarelli
LE
Tirico
Roberto Freire
RF
da Mota e Albuquerque
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome