前交叉韧带重建联合胫骨高位截骨治疗前交叉韧带损伤合并骨关节炎的临床疗效

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Abstract Objective To investigate the clinical effect of anterior cruciate ligament reconstruction combined with high tibial osteotomy in the treatment of anterior cruciate ligament injury combined with medial compartment osteoarthritis.Methods A retrospective analysis was performed on 18 patients with anterior cruciate ligament injury complicated by medial single-compartment osteoarthritis at the Second Hospital of Tangshan from June 2015 to February 2018.There were 10 males and 8 females with an average age of (51.20±4.80)years (range，42~57 years).Cruciate ligament reconstruction and tibial high osteotomy were performed simultaneously.Follow-up visits were made at 1，6，12 and 24 months after operation.Full-length radiographs of lower limbs and anteroposterial-lateral radiographs of affected knee were reviewed，the union of osteotomy line was investigated，and the passing point of mechanical axis of lower limb and posterior tibial angle were measured.At the last follow-up，Lachman test and KT-1000 test were performed to objectively evaluate the stability of the knee joint.Lysholm score，Tegner knee motion score and international knee documentation committee (IKDC) score were used to evaluate knee function.Results All patients were followed up for 24~36 months，with an average of (28.30±5.70)months.There was no joint stiffness，infection，bone nonunion or delayed union during the follow-up period.2 patients developed postoperative tibial vein thrombosis and received active antithrombotic therapy.At the last follow-up，Lysholm score，Tegner knee motion score and IKDC score were significantly improved compared with those before surgery(P<0.05).At last follow-up，the mechanical axis of lower extremity was adjusted from preoperative varus (7.05±2.34)° to postoperative valgus (1.22±0.43)°，and the difference was statistically significant (P<0.05).The posterior angle of tibial plateau was (9.16±1.41)° before operation and (10.24±2.37)° after operation，and the difference was not statistically significant (P>0.05).Continuous radiographs in 4 patients showed progressive medial compartment osteoarthritis exacerbation，Lachman test was positive in 3 cases.Conclusion Anterior cruciate ligament reconstruction combined with high tibial osteotomy can effectively improve joint stability and osteoarthritis symptoms，and the clinical effect is satisfactory，but the high rate of arthritis progression and ligament relaxation should not be ignored.

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	Articles by authors
	Liu Guoli
	Li Liang
	Yi Fan
	Xie Kunnan
	Yin Xianghui
	Zhang Yanrui
	Dai Shifeng

Cite this article:

Liu Guoli,Li Liang,Yi Fan, et al. Clinical Effect of Anterior Cruciate Ligament Reconstruction Combined with High Tibial Osteotomy in the Treatment of Anterior Cruciate Ligament Injury Combined with Osteoarthritis[J]. sygkzz, 2022, 28(8): 691-695.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I8/691

［1］Schuster P，Schulz M，Richter J.Combined biplanar high tibial osteotomy，anterior cruciate ligament reconstruction，and abrasion/microfracture in severe medial osteoarthritis of unstable varus knees［J］.Arthroscopy，2016，32(2)：283-292.
［2］王波，罗建成，魏增永，等.胫骨近端双平面开放截骨术联合关节镜清理治疗膝关节内侧间室骨性关节炎［J］.中国骨与关节损伤杂志，2019，34(2)：172-174.
［3］张建兵，陈百成，王飞，等.胫骨高位截骨联合膝关节镜下外侧支持带松解及清理术的临床疗效评价［J］.中国骨与关节损伤杂志，2009，24(7)：595-597.
［4］Cantivalli A，Rosso F，Bonasia DE，et al.High tibial osteotomy and anterior cruciate ligament reconstruction/revision［J］.Clin Sports Med，2019，38(3)：417-433.
［5］Gupta A，Tejpal T，Shanmugaraj A，et al.Surgical techniques，outcomes，indications，and complications of simultaneous high tibial osteotomy and anterior cruciate ligament revision surgery：A systematic Review［J］.HSS J，2019，15(2)：176-184.
［6］邓翔天，刘俊才，李忠，等.关节镜联合双平面胫骨高位截骨治疗前交叉韧带损伤伴下肢力线不良的早期疗效［J］.中华外科杂志，2020，58(3)：203-204.
［7］刘文斌，王磊，王文波，等.胫骨高位截骨联合韧带重建治疗膝内翻畸形合并前交叉韧带损伤［J］.疑难病杂志，2019，18(9)：928-931.
［8］陶建峰，王爱军，张德新，等.膝内翻骨关节炎合并前交叉韧带损伤的微创治疗［J］.中国骨与关节杂志，2013，2(12)：666-669.
［9］Marriott K，Birmingham TB，Kean CO，et al.Five-year changes in gait biomechanics after concomitant high tibial osteotomy and ACL reconstruction in atients with medial knee osteoarthritis［J］.Am J Sport Med，2015，43(9)：2277-2285.
［10］Zaffagnini S，Bonanzinga T，Grassi A，et al.Combined ACL reconstruction and closing-wedge HTO for varus angulated ACL-deficient knees［J］.Knee Surg Sports Traumatol Arthrosc，2013，21(4)：934-941.
［11］Dejour H，Neyret P，Boileau P，et al.Anterior cruciate reconstruction combined with valgus tibial osteotomy［J］.Clin Orthop Relat Res，1994(299)：220-228.
［12］Dean CS，Liechti DJ，Chahla J，et al.Clinical outcomes of high tibial osteotomy for knee instability：A systematic review［J］.Orthop J of Sports Med，2016，4(3)：1-9.
［13］Malahias MA，Shahpari O，Kaseta MK.The clinical outcome of one-stage high tibial osteotomy and anterior cruciate ligament reconstruction.A current concept systematic and comprehensive review［J］.Arch Bone Jt Surg，2018，6(3)：161-168.
［14］Vaishya R，Vijay V，Jha GK，et al.Prospective study of the anterior cruciate ligament reconstruction associated with high tibial opening wedge osteotomy in knee arthritis associated with instability［J］.J Clin Orthop Trauma，2016，7(4)：265-271.
［15］林晓东，郑沐欣，夏威夷，等.胫骨后倾角在膝关节手术中的临床意义［J］.中华创伤骨科杂志，2019，21(10)：914-915.
［16］刘中砥，许庭珉，党育，等.关节镜联合胫骨高位截骨治疗内侧间室膝关节骨关节炎的中期疗效分析［J］.中华骨与关节外科杂志，2020，13(12)：991-995.
［17］Jin C，Song EK，Jin QH，et al.Outcomes of simultaneous high tibial osteotomy and anterior cruciate ligament reconstruction in anterior cruciate ligament deficient knee with osteoarthritis［J］.BMC Musculoskelet Disord，2018，19(1)：228.

[1]	. [J]. sygkzz, 2022, 28(8): 750-754.