To study the results of high tibia osteotomy (HTO) combined with- posterior cruciate ligament (PCL) reconstruction for osteoarthritis (OA) of the medial compartment wit PCL injury.
Between March 2008 and June 2014, 11 patients with OA of the medial compartment and PCL injury underwent HTO combined with PCL reconstruction. There were 5 males and 6 females, aged 43-55 years (mean, 50.3 years). All patients had a trauma history, and the duration of injury was 3-5 years (mean, 3.7 years). At preoperation, Hospital for special surgery (HSS) score was 54.73 ± 8.60, Lyshoim score was 56.91 ± 4.51, KT-1000 test was (5.71 ± 1.13) mm, and knee range of motion (ROM) was (125.21 ± 4.77)degrees. The preoperative femoral tibia angle (FTA) and posterior slope angle (PSA) of the tibia plateau were (184.82 ± 2.40)degrees and (7.18± 1.17)degrees on the X-ray film.
Incisional fat liquefaction occurred in 1 case, and wound healed after dressing change; primary healing of wound was obtained in the other cases. All 11 cases were followed up 12-28 months (mean, 17 months). Bone union was observed at osteotomy site within 6 months, without delayed union or nonunion. After operation, genu varus deformity was corrected with different degrees; the stability of knees was improved in all patients; and the pain of medial knee was released significantly. At 12 months after operation, the FTA was significantly reduced to (176.64 ± 1.96)degrees; at last follow-up, the HSS score was significantly increased to 88.27 ± 4.76, KT-1000 test was significantly reduced to (3.18 ± 0.87) mm, and Lyholm score was significantly increased to 86.45 ± 2.34, all showing significant differences when compared with preoperative ones (P < 0.05). At last follow-up, the knee ROM was (124.63 ± 2.98)degrees and the PSA was (7.91 ± 1.30)degrees, showing no significant difference when compared with preoperative ones (P > 0.05).
The PSA will not be changed when a combination of HTO and PCL reconstruction is used to treat OA of the medial compartment with PCL injury if the right osteotomy site and reasonable bone graft are selected. The short-term effectiveness is good because of good recovery of the lower extremity force line and knee stability, but the long-term effectiveness remains to be further followed up.