Simultaneous medial opening wedge high tibial osteotomy and revision anterior cruciate ligament reconstruction using a bone-patella tendon-bone graft: A case report

Akihiko Yonekura; Yusuke Sugihara; Narihiro Okazaki; Kenichi Kidera; Yusuke Nakazoe; Masato Tomita; Makoto Osaki

doi:10.11343/amn.61.127

CASE REPORT

Simultaneous medial opening wedge high tibial osteotomy and revision anterior cruciate ligament reconstruction using a bone-patella tendon-bone graft: A case report

Akihiko Yonekura, Yusuke Sugihara, Narihiro Okazaki, Kenichi Kidera, Yusuke Nakazoe, Masato Tomita, Makoto Osaki

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Keywords: Anterior Cruciate Ligament Reconstruction, Revision surgery, Bone patella tendon bone graft, High Tibial Osteotomy, Knee Osteoarthritis

JOURNAL FREE ACCESS

2018 Volume 61 Issue 3 Pages 127-135

DOI https://doi.org/10.11343/amn.61.127

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Abstract

　It is said that the clinical results of cases with anterior cruciate ligament reconstruction (ACLR) who have knee osteoarthritis (OA) are not very good. A case of simultaneous medial opening wedge high tibial osteotomy (MOWHTO) and revision ACLR using a bone-patella tendon-bone (BPTB) graft for medial knee OA after re-tear of a reconstructed ACL graft is reported. 　The patient was a 49-year-old man who underwent surgery for a right knee ACL injury by ACLR using an ipsilateral hamstring tendon graft 7 years earlier. He sprained his right knee while he was skiing and injured his reconstructed ACL graft. He had knee instability and pain at the medial side of his knee. X-ray showed a tibia vara deformity and medial knee OA of KellgrenLawrence grade II. It was thought that the medial knee pain would remain if he were treated by revision ACLR alone. Therefore, simultaneous MOWHTO and revision ACLR using an ipsilateral BPTB graft were performed. The excellent clinical results and radiological findings 3 years after the operation indicate the usefulness of this approach.

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