RECONSTRUCTION OF THE ACL AND HIGH TIBIAL OSTEOTOMY AS A COMBINED PROCEDURE IN ANTERIOR INSTABILITY AND VARUS MALALIGNMENT

Besides patients having an acute rupture of the ACL with a clear thera peutical strategy there are increasingly young patients with chronical anterior instability and degenerative arthritis of the medial compart ment and varus malalignment. This constellation is taxing severely the operative procedure considering that there is not only the instabilit y which has to be treated but that also an improvement of the arthriti s symptomatology has to be achieved. Zn this paper we present a therap eutical concept of high tibial osteotomy combined with an arthroscopic assisted reconstruction of the ACL which is performed as a single pro cedure since the early 80-ies. The goal is to remove two severe arthro genic factors correcting the instability and the pathological anatomic al axis, to reduce the medial knee pain and to improve the use of the knee in life activities.