title: Clinical outcome of simultaneous high tibial osteotomy and anterior cruciate ligament reconstruction for medial compartment osteoarthritis in young patients with anterior cruciate ligament-deficient knees: a systematic review.
abstract: OBJECTIVE
  High tibial osteotomy (HTO) has been a well-established procedure addressing tibiofemoral osteoarthritis in young patients. However, for physically active patients with concomitant anterior cruciate ligament (ACL) injury, simultaneous HTO and ACL reconstruction is considered a salvage procedure. Controversy exists regarding the subjective and objective evaluations and the prevalence of complications.
  
  
  METHODS
  A search in the Medline database and of major orthopaedic journals was performed. Articles were included if they met the specific inclusion and exclusion criteria. Anterior knee laxity, osteoarthritis, subjective outcomes, sagittal and coronal alignment, and complications were analyzed.
  
  
  RESULTS
  A total of 721 articles were retrieved from the search, and 11 eligible studies (218 knees) were included for evaluation. Postoperatively, the mean side-to-side difference measured by KT-1000 (MEDmetric, San Diego, CA) was 2.4 mm, and 85.7% of patients gained grade A or B stability according to International Knee Documentation Committee evaluation. Medial compartment osteoarthritis showed a tendency of alleviation. Regardless of the scoring system, all subjective evaluations showed improvement and most of the participants returned to recreational sports. All cases of varus malalignment were corrected, with a mean value of 7.13°. The most prevalent complication was deep venous thrombosis (7.7%).
  
  
  CONCLUSIONS
  Simultaneous HTO and ACL reconstruction was a salvage procedure for physically active young patients because it provided satisfactory restoration of anterior stability, alleviation of medial compartment osteoarthritis, improvement of subjective evaluations, and a predictable return to recreational sports.
  
  
  METHODS
  Level IV, systematic review of Level III and IV studies.
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Li
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Guanyang
authors.initials: G
authors.lastname: Song
authors.affiliation: Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China. Electronic address: fenghua20080617@126.com.
authors.forename: Hua
authors.initials: H
authors.lastname: Feng
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D007718:Knee Injuries / Q000150:complications / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000209:etiology / Q000601:surgery*; D010027:Osteotomy; D016896:Treatment Outcome