ArticleArchives of orthopaedic and trauma surgery2023
Is there any benefit in the combined ligament reconstruction with osteotomy compared to ligament reconstruction or osteotomy alone?: Comparative outcome analysis according to the degree of medial compartment osteoarthritis with anterior or posterior cruciate ligament insufficiency.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Simultaneous anterior cruciate ligament reconstruction with valgus high tibial osteotomy improves mid- to long-term clinical outcomes without increasing the complication rates in young anterior cruciate ligament deficient patients with varus malalignment: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Varus aligned patients have decreased patient reported International Knee Documentation Committee, knee injury and osteoarthritis outcome score sports scores and Tegner activity levels compared to neutral aligned patients in primary anterior cruciate ligament reconstructions.Journal of experimental orthopaedics · 2025Article
- Biomechanical effects of LCWHTO vs. MOWHTO on medial meniscus posterior root repair: a finite element analysis.Scientific reports · 2025Article
- Clinical outcomes and long-term efficacy of high tibial osteotomy in treating knee instability: An updated systematic review.SICOT-J · 2025Article
- Association of Posterior Tibial Slope With Outcomes After Multiligamentous Knee Reconstruction for Knee Dislocation Grades 2 to 4.Orthopaedic journal of sports medicine · 2024Article
- Effect of Posterior Tibial Slope on Outcomes After Posterior Cruciate Ligament Reconstruction.Orthopaedic journal of sports medicine · 2024Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe purpose of this study was to compare the outcomes of middle-aged patients with anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) insufficiency by assessing different groups: high tibial osteotomy (HTO), HTO with combined ligament reconstruction, and isolated ligament reconstruction according to the alignment change and medial compartment osteoarthritis (OA). MATERIALS AND
methodsFrom 2014 to 2019, middle-aged (40-65 years) patients with knee instability were enrolled in this retrospective study. They were categorized into three groups: group I, HTO; group II, HTO with combined ACL or PCL reconstruction; and group III, isolated ligament reconstruction. Radiological outcomes, including Kellgren-Lawrence grade, mechanical femorotibial angle (mFTA), weight-bearing line (WBL) ratio, and posterior tibial slope were compared. Knee stability and clinical outcomes were also compared.
resultsSeventy-nine patients completed the final assessment. Group I was older than other two groups (p = 0.006). Groups I and II had a higher body mass index (p = 0.043) and more preoperative varus alignment than group III (p < 0.001). OA severity was ranked in the order of group I, II, and III (p < 0.001). Group I showed more valgus alignment than group II after HTO (p = 0.024 for mFTA and 0.044 for WBL ratio, respectively). Compared to their preoperative status, all three groups showed significant improvement in knee stability (p < 0.001); however, group I showed inferior knee stability regardless of ACL or PCL reconstruction (p < 0.001 and 0.043, respectively). All clinical scores significantly improved in the three groups (p < 0.001), and they showed comparable clinical outcomes in the final assessment.
conclusionsOur strategy in managing middle-aged patients with knee instability according to the varus alignment and medial degeneration showed favorable stability and clinical outcomes. Middle-aged patients with knee instability should be managed with different strategies depending on their status. LEVEL OF EVIDENCE: Case-control study; Level-III.
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