Simultaneous High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction in knees with Bony Frontal and/or Sagittal Deformities: Review of the Current Literature

Simultaneous anterior cruciate ligament (ACL) reconstruction (ACLR) and valgus high tibial osteotomy (HTO) alleviates pain in ۷۰% of individuals with ACL deficiency and varus femorotibial osteoarthritis, allows for sustainable stabilization of the knee at the ۱۰-year follow-up and a return to sport (RTS) in ۳۳%-۸۰% of cases, but femorotibial osteoarthritis progression occurs in ۳۹% of cases. The complication rate ranges from ۰% to ۲۳.۵% (۶.۵% revision valgus HTO, ۱۷.۵% ACL graft failure, ۷.۷% venous thrombosis). Simultaneous ACLR and HTO leads to satisfactory results in patients with ACL deficiency and varus femorotibial osteoarthritis associated with a high posterior tibial slope (PTS) and appears to have a protective effect on further ruptures in the reconstructed ACL. The younger the patient and the more sporting demands he/she poses, the more we should be inclined to perform a combined intervention (ACLR and valgus HTO).        Level of evidence: III

Keywords:

combined chronic ACL deficiency and varus osteoarthritis , Results , simultaneous valgus high tibial osteotomy and ACL reconstruction