A Systematic Review of Simultaneous Versus Staged Anterior Cruciate Ligament Reconstruction and Opening Wedge High Tibial Osteotomy for Varus Malalignment in Young Patients with Anterior Cruciate Ligament Deficient Knees

Abstract

Anterior cruciate ligament (ACL) tear induces progressive deterioration in knee structures. In the meniscus, secondary lesions are often medial, occurring within 5 to 10 years after the ligament lesion, and are followed by cartilage lesions that lead to osteoarthritis. Osteoarthritis involves usually the medial tibiofemoral compartment, especially following medial meniscectomy. ACL reconstruction achieves knee stability and can limit the osteoarthritic process. Valgus high tibial osteotomy (HTO) limits the evolution of medial tibiofemoral osteoarthritis in varus knees. Combined ACL reconstruction and valgus HTO (ACL-HTO) stabilizes the knee and counters osteoarthritic evolution. The present study is a systematic review discussing the simultaneous versus staged anterior cruciate ligament (ACL) reconstruction and opening wedge high tibial osteotomy as regard clinical outcomes and complications, eight studies were included with a total of number of patients = 222 with average age ranged from 35.4 to 54.2 years, they were 172 male and 50 female. The results of our study showed a highly statistical significant difference (to HTO-ACLR group) between the included studies regarding type of operation and the majority o