Paper #IV-4

OUTCOME FOLLOWING SIMULTANEOUS ACL RECONSTRUCTION AND HIGH TIBIAL OSTEOTOMY

Jerome DaSilva, MD

London, ON

Co-Authors

N. Gaveleau

R. Giffin

P. Fowler

R. Litchfield

N. Amendola

We treated 40 patients who had anterior cruciate ligament deficiency and varus mal-alignment of their affected lower extremity. Patients were treated with ACL reconstruction and simultaneous medial opening wedge high tibial osteotomy. Preliminary review of the data indicates average age was 37 years at time of surgery, with all patients being recreationally active or participating in laboring jobs. Pre-operatively, all patients had knee instability, pain, varus angulation, and 15 patients had previous arthroscopic knee surgery. Average follow up is 30 months. Post-operatively all but 3 patients have been able to return to pre-operative activity levels and have remained ligmentously stable with radiographic and clinical evidence of osteotomy healing. One patient has required ACL revision, one had an infection and one has anterior laxity with tibial tunnel widening. On average, mechanical axis medial deviation was corrected from 24.64mm to 7.32mm, mechanical axis angle was corrected from 6.4 degrees of valgus to 0.28 degrees of valgus, tibial slope was increased from 8.03 degrees to 11.1 degrees, and patellar height ratio was decreased from 1.04 to .87. Combining ACL reconstruction and medial opening wedge HTO in a simultaneous procedure accomplishes a ligamentously stable knee with corrected alignment, allowing patients to return to activity.