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- W2022273043 abstract "Purpose: Simultaneous anterior cruciate ligament (ACL) reconstruction and high tibial osteotomy (HTO) is a combined surgical procedure intended to improve kinematics and kinetics in the unstable knee with varus malalignment and medial compartment knee OA. The primary objective of this study was to compare three-dimensional (3D) gait biomechanics bilaterally between two groups of patients with concomitant ACL-deficiency, varus malalignment and medial compartment knee OA. One group received simultaneous medial opening-wedge HTO and ACL reconstruction (ACLR) while the second group received HTO alone (ACLD). Secondary objectives were to compare radiographic alignment (mechanical axis angle, MAA) and Knee Osteoarthritis Outcome Scores (KOOS) before and after surgery. Methods: Each group consisted of thirty-two patients with medial compartment knee OA and ACL deficiency, matched for age (42 ± 8 years [ACLR] and 43 ± 9 years [ACLD]) and varus malalignment (MAA = ̶ 6.8 ± 2.4° [ACLR] and ̶ 8.1 ± 2.9 [ACLD]). Patients completed 3D gait analysis, full-limb standing anteroposterior radiographs and KOOS preoperatively and 2 years postoperatively. Results: Analysis of variance indicated a significant time (pre, post 24 months) by limb (surgical, non-surgical) interaction for the peak knee adduction moment and varus angle; however, there were no between-group (ACLR, ACLD) differences. For both groups, there was a decrease in the peak knee adduction moment [‒1.65%BW×Ht (‒1.86, ‒1.44)] and varus angle [‒8.59° (‒9.72, ‒7.45)] in the surgical limb from preoperative to 2 years postoperative. There were also no between-group differences for either the peak knee flexion moment or angle. For both groups, there was a decrease in the peak knee flexion moment from preoperative to 2 years postoperative for both the surgical [ACLR: ‒0.32%BW×Ht (‒0.81, 0.17) and ACLD: ‒0.55%BW×Ht (‒0.92, ‒0.18)] and non-surgical [ACLR: ‒0.52%BW×Ht (‒0.94, ‒0.09) and ACLD: ‒0.70%BW×Ht (‒1.10, ‒0.29)] limbs. Although there was no change in the peak knee flexion angle in the surgical limb, there was a decrease in the non-surgical limb from preoperative to 2 years postoperative [ACLR: ‒2.19° (‒3.79, ‒0.58) and ACLD: ‒3.39° (‒5.76, ‒1.02)]. There was also an increase in the peak knee extension moment from preoperative to 2 years postoperative for both the surgical [ACLR: 0.21%BW×Ht (‒0.21, 0.64) and ACLD: 0.74%BW×Ht (0.28, 1.20)] and non-surgical [ACLR: 0.53%BW×Ht (0.06, 0.99) and ACLD: 0.74%BW×Ht (0.33, 1.16)] limbs. Although there was no change in the peak knee extension angle in the surgical limb from preoperative to 2 years postoperative, there was an increase in the non-surgical limb [ACLR: 1.75° (0.21, 3.30) and ACLD: 3.44° (1.19, 5.69)]. There was a significant time by limb interaction for the peak knee internal rotation moment; however, there were no between-group differences. There was a decrease in the peak internal rotation moment in the surgical limb from preoperative to 2 years postoperative [ACLR: ‒0.59%BW×Ht (‒0.71, ‒0.47) and ACLD: ‒0.47%BW×Ht (‒0.36, ‒0.59)], although there was no change in the peak internal rotation angle. The MAA in the surgical limb was altered by [8.65° (7.36, 9.94)] and [9.43° (8.33, 10.5)] for the ACLR and ACLD groups, respectively. There was no change in alignment of the non-surgical limb for either group. There were similar improvements in each of the KOOS domains from preoperative to 2 years postoperative for both groups. Conclusions: Overall, our results indicate that individuals with varus malalignment and ACL deficiency who undergo medial opening-wedge HTO experience similar long-term changes in knee moments during walking in all three orthogonal planes with our without concomitant ACL reconstruction." @default.
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- W2022273043 date "2015-04-01" @default.
- W2022273043 modified "2023-09-30" @default.
- W2022273043 title "Gait biomechanics after combined HTO/ACL reconstruction versus HTO alone: A matched cohort study" @default.
- W2022273043 doi "https://doi.org/10.1016/j.joca.2015.02.828" @default.
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