ANTERIOR CRUCIATE RECONSTRUCTION COMBINED WITH VALGUS TIBIAL OSTEOTOMY

Forty-four of the first 50 knees to undergo anterior cruciate ligament (ACL) reconstruction combined with a valgus tibial osteotomy were rev iewed retrospectively at an average of three and a half years later. T he combined operation was performed on patients with symptomatic chron ic ACL rupture who also had varus malalignment on unilateral weight be aring, usually secondary to a previous medial meniscectomy. All patien ts originally played regular sports, but before the combined operation , 31 did not play at all. The operation had a low morbidity, and signi ficantly improved clinical symptoms, clinical stability, and functiona l stability. Postoperatively only one patient could play competitive s ports, although a further 26 could play leisure sports. At review ther e was no radiological progression of osteoarthrosis, and 37 patients ( 91%) were satisfied or very satisfied with the operation. Performing a valgus tibial osteotomy improved the results of ACL reconstruction in patients with acquired varus malalignment and extended the indication s for ACL reconstruction to include patients younger than 40 years of age with early medial compartment osteoarthrosis.