Deng FY, Liu JC, Li Z. Osteotomy combined with anterior cruciate ligament reconstruction for anterior cruciate ligament injury and biplanar deformity. World J Clin Cases 2024; 12(22): 4897-4904 [PMID: 39109021 DOI: 10.12998/wjcc.v12.i22.4897]
Corresponding Author of This Article
Zhong Li, PhD, Academic Research, Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou 646000, Sichuan Province, China. lizhou3165@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2024; 12(22): 4897-4904 Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4897
Osteotomy combined with anterior cruciate ligament reconstruction for anterior cruciate ligament injury and biplanar deformity
Fu-Yuan Deng, Jun-Cai Liu, Zhong Li
Fu-Yuan Deng, Department of Orthopedics, Deyang People’s Hospital/Orthopedic Center of Deyang City, Deyang 618000, Sichuan Province, China
Jun-Cai Liu, Zhong Li, Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Jun-Cai Liu, Zhong Li, Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou 646000, Sichuan Province, China
Author contributions: Li Z and Liu JC designed this study; Deng FY wrote the manuscript; Li Z and Liu JC performed the surgery.
Institutional review board statement: This article is a retrospective study and does not involve matters of patient safety or interests.
Informed consent statement: Informed consent to participate in this study was obtained from each patient.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong Li, PhD, Academic Research, Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou 646000, Sichuan Province, China. lizhou3165@163.com
Received: February 22, 2024 Revised: May 28, 2024 Accepted: June 21, 2024 Published online: August 6, 2024 Processing time: 130 Days and 19.8 Hours
Abstract
BACKGROUND
It has been confirmed that the increased posterior tibial slope over 12 degrees is a risk factor for anterior cruciate ligament injury, and varus deformity can aggravate the progression of medial osteoarthritis.
AIM
To evaluate the efficacy of modified high tibial osteotomy (HTO) and anterior cruciate ligament reconstruction (ACLR) in the treatment of anterior cruciate ligament (ACL) injuries with varus deformities and increased posterior tibial slope (PTS) based on clinical and imaging data.
METHODS
The patient data in this retrospective study were collected from 2019 to 2021. A total of 6 patients were diagnosed with ACL injury combined with varus deformities and increased PTS. All patients underwent modified open wedge HTO and ACLR. The degree of correction of varus deformity and the PTS was evaluated by radiography and magnetic resonance imaging.
RESULTS
All 6 patients (6 knee joints) were followed up for an average of 20.8 ± 3.7 months. The average age at surgery was 29.5 ± 3.8 years. At the last follow-up, all patients resumed competitive sports. The International Knee Documentation Committee score increased from 50.3 ± 3.1 to 87.0 ± 2.8, the Lysholm score increased from 43.8 ± 4.9 to 86 ± 3.1, and the Tegner activity level increased from 2.2 ± 0.7 to 7.0 ± 0.6. The average movement distance of the tibia anterior translation was 4.8 ± 1.1 mm, medial proximal tibial angle (MPTA) was 88.9 ± 1.3° at the last follow-up, and the PTS was 8.4 ± 1.4°, both of which were significantly higher than those before surgery (P < 0.05).
CONCLUSION
Modified open wedge HTO combined with ACLR can effectively treat patients with ACL ruptures with an associated increased PTS and varus deformity. The short-term effect is significant, but the long-term effect requires further follow-up.
Core Tip: Some patients anterior cruciate ligament injury have sagittal varus deformity and coronal increased posterior tibial slope. We can correct the biplanar deformity simultaneously with a modified osteotomy.
