In a consecutive series, we treated 41 young patients who had anterior cruciate ligament deficiency, lower limb varus angulation, and varying amounts of posterolateral ligament deficiency. Seventy-three percent of the patients (N = 30) had lost the medial meniscus and 63% (N = 26) had marked articular cartilage damage in the medial compartment. All patients were treated with high tibial osteotomy and, in the majority (N = 34), anterior cruciate ligament reconstruction a mean of 8 months later. Posterolateral reconstructions were also required in 18 knees. A 100% follow-up was obtained at a mean of 4.5 years after osteotomy. Gait analysis testing was done in 17 knees before and after osteotomy. At follow-up, a reduction in pain was found in 71% (29 knees); elimination of giving way, in 85% (35 knees); and resumption of light recreational activities without symptoms, in 66% (27 knees). The patient rating of the knee condition was normal or very good in 37% (15 knees) and good in 34% (14 knees). The mean Cincinnati Knee Rating Score significantly improved from 63 to 82 points. The mean adduction moment, 35% higher than controls preoperatively, significantly decreased to below normal values postoperatively. Correction of varus alignment was maintained in 33 knees (80%). We recommend osteotomy in addition to ligament reconstructive procedures in these knees with complex injury patterns.





Polls results
1

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
100% Article relates to my practice (9/9)
0% Article does not relate to my practice (0/9)
0% Undecided (0/9)
2

Will this article lead to more cost-effective healthcare?

77% Yes (7/9)
22% No (2/9)
0% Undecided (0/9)
3

Was this article biased? (commercial or personal)

0% Yes (0/8)
87% No (7/8)
12% Undecided (1/8)
4

What level of evidence do you think this article is?

11% Level 1 (1/9)
11% Level 2 (1/9)
33% Level 3 (3/9)
44% Level 4 (4/9)
0% Level 5 (0/9)