Osteotomy for the early varus arthritic knee

Sports Medicine and Arthroscopy Review

Volumn 15, Issue 1, 2007, Pages 3-14

  Parker, David A ^a,b   Viskontas, Darius G ^a  

^a ROYAL NORTH SHORE HOSPITAL   (Australia)

^b The Gallery   (Australia)

Author keywords

Arthritis; High tibial osteotomy; Knee; Lateral closing wedge; Medial opening wedge; Varus deformity

Indexed keywords

ANTHROPOMETRIC PARAMETERS; ARTERY INJURY; COMPARTMENT SYNDROME; COMPUTER ANALYSIS; DOME OSTEOTOMY; FRACTURE; FRACTURE EXTERNAL FIXATION; FRACTURE NONUNION; HUMAN; KNEE ARTHRITIS; LATERAL CLOSING WEDGE OSTEOTOMY; LIGAMENT SURGERY; LIMB ALIGNMENT; MEDIAL OPENING WEDGE OSTEOTOMY; NERVE INJURY; OSTEOSYNTHESIS; PATIENT SELECTION; PERONEUS NERVE PARALYSIS; POSTOPERATIVE INFECTION; PRIORITY JOURNAL; PSEUDARTHROSIS; REVIEW; RISK; SURGICAL TECHNIQUE; THROMBOEMBOLISM; TIBIA OSTEOTOMY; TREATMENT INDICATION; VARUS KNEE;

AGED; FEMALE; HUMANS; INTERNAL FIXATORS; JOINT DEFORMITIES, ACQUIRED; MALE; MIDDLE AGED; MONITORING, INTRAOPERATIVE; OSTEOARTHRITIS, KNEE; OSTEOTOMY; PATIENT SELECTION; PROGNOSIS; RANGE OF MOTION, ARTICULAR; RECOVERY OF FUNCTION; SEVERITY OF ILLNESS INDEX; SURGERY, COMPUTER-ASSISTED; SURGICAL WOUND INFECTION; TREATMENT OUTCOME;

EID: 33846954416     PISSN: 10628592     EISSN: 15381951     Source Type: Journal    
DOI: 10.1097/JSA.0b013e3180303592     Document Type: Review

References (120)

1. Aaron RK, Skolnick AH, Reinert SE, et al. Arthroscopic debridement for osteoarthritis of the knee. J Bone Joint Surg Am. 2006;88:936-943.
2. Day B. The indications for arthroscopic debridement for osteoarthritis of the knee. Orthop Clin North Am. 2005;36:413-417.
3. Calvert GT, Wright RW. The use of arthroscopy in the athlete with knee osteoarthritis. Clin Sports Med. 2005;24:133-152.
4. Dervin GF, Stiell IG, Rody K, et al. Effect of arthroscopic debridement for osteoarthritis of the knee on health-related quality of life. J Bone Joint Surg Am. 2003;85-A:10-19.
5. Harwin SF. Arthroscopic debridement for osteoarthritis of the knee: predictors of patient satisfaction. Arthroscopy. 1999;15:142-146.
6. Moseley JB, O'Malley K, Petersen NJ, et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2002;347:81-88.
7. Furnes O, Espehaug B, Lie SA, et al. Early failures among 7,174 primary total knee replacements: a follow-up study from the Norwegian Arthroplasty Register 1994-2000. Acta Orthop Scand. 2002;73:117-129.
8. Diduch DR, Insall JN, Scott WN, et al. Total knee replacement in young, active patients. Long-term follow-up and functional outcome. J Bone Joint Surg Am. 1997;79:575-582.
9. Buechel FF. Knee arthroplasty in post-traumatic arthritis. J Arthroplasty. 2002;17:63-68.
10. Hinterwimmer S, von Eisenhart-Rothe R, Siebert M, et al. Patella kinematics and patello-femoral contact areas in patients with genu varum and mild osteoarthritis. Clin Biomech (Bristol, Avon). 2004;19:704-710.
11. Nguyen C, Rudan J, Simurda MA, et al. High tibial osteotomy compared with high tibial and Maquet procedures in medial and patellofemoral compartment osteoarthritis. Clin Orthop Relat Res. 1989;245:179-187.
12. Keene JS, Monson DK, Roberts JM, et al. Evaluation of patients for high tibial osteotomy. Clin Orthop Relat Res. 1989;243:157-165.
13. Hoell S, Suttmoeller J, Stoll V, et al. The high tibial osteotomy, open versus closed wedge, a comparison of methods in 108 patients. Arch Orthop Trauma Surg. 2005;125:638-643.
14. Williams RJ III, Kelly BT, Wickiewicz TL, et al. The short-term outcome of surgical treatment for painful varus arthritis in association with chronic ACL deficiency. J Knee Surg. 2003;16:9-16.
15. Goradia VK, Van Allen J. Chronic lateral knee instability treated with a high tibial osteotomy. Arthroscopy. 2002;18:807-811.
16. Lattermann C, Jakob RP. High tibial osteotomy alone or combined with ligament reconstruction in anterior cruciate ligament-deficient knees. Knee Surg Sports Traumatol Arthrosc. 1996;4:32-38.
17. O'Neill DF, James SL. Valgus osteotomy with anterior cruciate ligament laxity. Clin Orthop Relat Res. 1992;278:153-159.
18. Polyzois D, Stavlas P, Polyzois V, et al. The oblique high tibial osteotomy technique without bone removal and with rigid blade plate fixation for the treatment of medial osteoarthritis of the varus knee: medium and long-term results. Knee Surg Sports Traumatol Arthrosc. 2006;14:940-947.
19. Chiang H, Hsu HC, Jiang CC. Dome-shaped high tibial osteotomy: a long-term follow-up study. J Formos Med Assoc. 2006;105:214-219.
20. Wu LD, Hahne HJ, Hassenpflug T. A long-term follow-up study of high tibial osteotomy for medial compartment osteoarthrosis. Chin J Traumatol. 2004;7:348-353.
21. Pfahler M, Lutz C, Anetzberger H, et al. Long-term results of high tibial osteotomy for medial osteoarthritis of the knee. Acta Chir Belg. 2003;103:603-606.
22. Sprenger TR, Doerzbacher JF. Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J Bone Joint Surg Am. 2003;85-A:469-474.
23. Flamme CH, Ruhmann O, Schmolke S, et al. Long-term outcome following high tibial osteotomy with tension bend principle. Arch Orthop Trauma Surg. 2003;123:12-16.
24. Aglietti P, Buzzi R, Vena LM, et al. High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg. 2003;16:21-26.
25. Choi HR, Hasegawa Y, Kondo S, et al. High tibial osteotomy for varus gonarthrosis: a 10- to 24-year follow-up study. J Orthop Sci. 2001;6:493-497.
26. Billings A, Scott DF, Camargo MP, et al. High tibial osteotomy with a calibrated osteotomy guide, rigid internal fixation, and early motion. Long-term follow-up. J Bone Joint Surg Am. 2000;82:70-79.
27. Korovessis P, Katsoudas G, Salonikides P, et al. Medium- and long-term results of high tibial osteotomy for varus gonarthrosis in an agricultural population. Orthopedics. 1999;22:729-736.
28. Rinonapoli E, Mancini GB, Corvaglia A, et al. Tibial osteotomy for varus gonarthrosis. A 10- to 21-year followup study. Clin Orthop Relat Res. 1998;353:185-193.
29. Odenbring S, Egund N, Hagstedt B, et al. Ten-year results of tibial osteotomy for medial gonarthrosis. The influence of overcorrection. Arch Orthop Trauma Surg. 1991;110:103-108.
30. Ivarsson I, Myrnerts R, Gillquist J. High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg Br. 1990;72:238-244.
31. Hernigou P, Medevielle D, Debeyre J, et al. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am. 1987;69:332-354.
32. Insall JN, Joseph DM, Msika C. High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am. 1984;66:1040-1048.
33. Coventry MB. Upper tibial osteotomy. Clin Orthop Relat Res. 1984;182:46-52.
34. Aglietti P, Rinonapoli E, Stringa G, et al. Tibial osteotomy for the varus osteoarthritic knee. Clin Orthop Relat Res. 1983;176:239-251.
35. Naudie D, Bourne RB, Rorabeck CH, et al. The Install Award. Survivorship of the high tibial valgus osteotomy. A 10- to 22-year followup study. Clin Orthop Relat Res. 1999;367:18-27.
36. Berman AT, Bosacco SJ, Kirshner S, et al. Factors influencing long-term results in high tibial osteotomy. Clin Orthop Relat Res. 1991;272:192-198.
37. Stukenborg-Colsman C, Wirth CJ, Lazovic D, et al. High tibial osteotomy versus unicompartmental joint replacement in unicompartmental knee joint osteoarthritis: 7-10-year follow-up prospective randomised study. Knee. 2001;8:187-194.
38. Yasuda K, Majima T, Tsuchida T, et al. A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res. 1992;282:186-195.
39. Majima T, Yasuda K, Katsuragi R, et al. Progression of joint arthrosis 10 to 15 years after high tibial osteotomy. Clin Orthop Relat Res. 2000;381:177-184.
40. Vainionpaa S, Laike E, Kirves P, et al. Tibial osteotomy for osteoarthritis of the knee. A five to ten-year follow-up study. J Bone Joint Surg Am. 1981;63:938-946.
41. Koshino T, Wada S, Ara Y, et al. Regeneration of degenerated articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis of the knee. Knee. 2003;10:229-236.
42. Kanamiya T, Naito M, Hara M, et al. The influences of biomechanical factors on cartilage regeneration after high tibial osteotomy for knees with medial compartment osteoarthritis: clinical and arthroscopic observations. Arthroscopy. 2002;18:725-729.
43. Sterett WI, Steadman JR. Chondral resurfacing and high tibial osteotomy in the varus knee. Am J Sports Med. 2004;32:1243-1249.
44. Minas T, Peterson L. Advanced techniques in autologous chondrocyte transplantation. Clin Sports Med. 1999;18:13-44, v-vi.
45. Bruns J, Steinhagen J. Treatment of deep hyalin cartilage defects with autologous perichondrial grafts. Int J Sports Med. 2003;24:382-388.
46. Madan S, Ranjith RK, Fiddian NJ. Intermediate follow-up of high tibial osteotomy: a comparison of two techniques. Bull Hosp Joint Dis. 2002;61:11-16.
47. Catani F, Marcacci M, Benedetti MG, et al. The influence of clinical and biomechanical factors on the results of valgus high tibial osteotomy. Chir Organ Mov. 1998;83:249-262.
48. Marti CB, Gautier E, Wachtl SW, et al. Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy. 2004;20:366-372.
49. Koshino T, Murase T, Saito T. Medial opening-wedge high tibial osteotomy with use of porous hydroxyapatite to treat medial compartment osteoarthritis of the knee. J Bone Joint Surg Am. 2003;85-A:78-85.
50. Rudan J, Harrison M, Simurda MA. Optimizing femorotibial alignment in high tibial osteotomy. Can J Surg. 1999;42:366-370.
51. Magyar G, Toksvig-Larsen S, Lindstrand A. Open wedge tibial osteotomy by callus distraction in gonarthrosis. Operative technique and early results in 36 patients. Acta Orthop Scand. 1998;69:147-151.
52. Riegger-Krugh C, Gerhart TN, Powers WR, et al. Tibiofemoral contact pressures in degenerative joint disease. Clin Orthop Relat Res. 1998;348:233-245.
53. Koshino T, Yoshida T, Ara Y, et al. Fifteen to twenty-eight years' follow-up results of high tibial valgus osteotomy for osteoarthritic knee. Knee. 2004;11:439-444.
54. Koshino T, Saito T, Orito K, et al. Increase in range of knee motion to obtain floor sitting after high tibial osteotomy for osteoarthritis. Knee. 2002;9:189-196.
55. Nakhostine M, Friedrich NF, Muller W, et al. A special high tibial osteotomy technique for treatment of unicompartmental osteoarthritis of the knee. Orthopedics. 1993;16:1255-1258.
56. Specchiulli F, Laforgia R, Solarino GB. Tibial osteotomy in the treatment of varus osteoarthritic knee. Ital J Orthop Traumatol. 1990;16:507-514.
57. Fujisawa Y, Masuhara K, Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am. 1979;10:585-608.
58. Goh JC, Bose K, Khoo BC. Gait analysis study on patients with varus osteoarthrosis of the knee. Clin Orthop Relat Res. 1993;294:223-231.
59. Kawakami H, Sugano N, Yonenobu K, et al. Change in the locus of dynamic loading axis on the knee joint after high tibial osteotomy. Gait Posture. 2005;21:271-278.
60. Wada M, Imura S, Nagatani K, et al. Relationship between gait and clinical results after high tibial osteotomy. Clin Orthop Relat Res. 1998;354:180-188.
61. Coventry MB. Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am. 1965;47:984-990.
62. Korn MW. A new approach to dome high tibial osteotomy. Am J Knee Surg. 1996;9:12-21.
63. Hsu RW. The study of maquet dome high tibial osteotomy. Arthroscopic-arthassisted analysis. Clin Orthop Relat Res. 1989;243:280-285.
64. Flierl S, Sabo D, Hornig K, et al. Open wedge high tibial osteotomy using fractioned drill osteotomy: a surgical modification that lowers the complication rate. Knee Surg Sports Traumatol Arthrosc. 1996;4:149-153.
65. Staubli AE, De Simoni C, Babst R, et al. TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia - early results in 92 cases. Injury. 2003;34(suppl 2):B55-B62.
66. Keppler P, Gebhard F, Grutzner PA, et al. Computer aided high tibial open wedge osteotomy. Injury. 2004;35(suppl 1):S-A68-S-A78.
67. Naudie DD, Amendola A, Fowler PJ. Opening wedge high tibial osteotomy for symptomatic hyperextension-varus thrust. Am J Sports Med. 2004;32:60-70.
68. Asik M, Sen C, Kilic B, et al. High tibial osteotomy with Puddu plate for the treatment of varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc. 2006;14:948-954.
69. Jokio PJ, Lindholm TS. The angle-measuring device, a practical resource in high tibial osteotomy. Ann Chir Gynaecol. 1991;80:54-58.
70. Hofmann AA, Wyatt RW, Beck SW. High tibial osteotomy. Use of an osteotomy jig, rigid fixation, and early motion versus conventional surgical technique and cast immobilization. Clin Orthop Relat Res. 1991;271:212-217.
71. Haddad FS, Bentley G. Total knee arthroplasty after high tibial osteotomy: a medium-term review. J Arthroplasty. 2000;15:597-603.
72. Bathis H, Perlick L, Tingart M, et al. Flexion gap configuration in total knee arthroplasty following high tibial osteotomy. Int Orthop. 2004;28:366-369.
73. Madan S, Ranjith RK, Fiddian NJ. Total knee replacement following high tibial osteotomy. Bull Hosp Joint Dis. 2002;61:5-10.
74. Karabatsos B, Mahomed NN, Maistrelli GL. Functional outcome of total knee arthroplasty after high tibial osteotomy. Can J Surg. 2002;45:116-119.
75. Noda T, Yasuda S, Nagano K, et al. Clinico-radiological study of total knee arthroplasty after high tibial osteotomy. J Orthop Sci. 2000;5:25-36.
76. Hile DD, Kirker-Head C, Doherty SA, et al. Mechanical evaluation of a porous bone graft substitute based on poly-(propylene glycol-co-fumaric acid). J Biomed Mater Res B Appl Biomater. 2003;66:311-317.
77. Backstein D, Meisami B, Gross AE. Patella baja after the modified Coventry-Maquet high tibial osteotomy. J Knee Surg. 2003;16:203-208.
78. Kaper BP, Bourne RB, Rorabeck CH, et al. Patellar infera after high tibial osteotomy. J Arthroplasty. 2001;16:168-173.
79. Westrich GH, Peters LE, Haas SB, et al. Patella height after high tibial osteotomy with internal fixation and early motion. Clin Orthop Relat Res. 1998;354:169-174.
80. Okamoto R, Koshino T, Morii T. Shortening of patellar ligament and patella baja with improvement of quadriceps muscle strength after high tibial osteotomy. Bull Hosp Joint Dis. 1993;53:21-24.
81. Wright JM, Heavrin B, Begg M, et al. Observations on patellar height following opening wedge proximal tibial osteotomy. Am J Knee Surg. 2001;14:163-173.
82. Tigani D, Ferrari D, Trentani P, et al. Patellar height after high tibial osteotomy. Int Orthop. 2001;24:331-334.
83. Brouwer RW, Bierma-Zeinstra SM, vanKoeveringe AJ, et al. Patellar height and the inclination of the tibial plateau after high tibial osteotomy. The open versus the closed-wedge technique. J Bone Joint Surg Br. 2005;87:1227-1232.
84. Kawakami H, Sugano N, Yonenobu K, et al. Effects of rotation on measurement of lower limb alignment for knee osteotomy. J Orthop Res. 2004;22:1248-1253.
85. Saragaglia D, Roberts J. Navigated osteotomies around the knee in 170 patients with osteoarthritis secondary to genu varum. Orthopedics. 2005;28:s1269-s1274.
86. Miller BS, Dorsey WO, Bryant CR, et al. The effect of lateral cortex disruption and repair on the stability of the medial opening wedge high tibial osteotomy. Am J Sports Med. 2005;33:1552-1557.
87. Lobenhoffer P, Agneskirchner JD. Improvements in surgical technique of valgus high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. 2003;11:132-138.
88. Noyes FR, Goebel SX, West J. Opening wedge tibial osteotomy: the 3-triangle method to correct axial alignment and tibial slope. Am J Sports Med. 2005;33:378-387.
89. Catagni MA, Guerreschi F, Ahmad TS, et al. Treatment of genu varum in medial compartment osteoarthritis of the knee using the Ilizarov method. Orthop Clin North Am. 1994;25:509-514.
90. Weale AE, Lee AS, MacEachern AG. High tibial osteotomy using a dynamic axial external fixator. Clin Orthop Relat Res. 2001;382:154-167.
91. Kitson J, Weale AE, Lee AS, et al. Patellar tendon length following opening wedge high tibial osteotomy using an external fixator with particular reference to later total knee replacement. Injury. 2001;32(suppl 4):SD140-SD143.
92. Fowler JL, Gie GA, Maceachern AG. Upper tibial valgus osteotomy using a dynamic external fixator. J Bone Joint Surg Br. 1991;73:690-691.
93. Schwartsman V. Circular external fixation in high tibial osteotomy. Instr Course Lect. 1995;44:469-474.
94. Nakamura E, Mizuta H, Kudo S, et al. Open-wedge osteotomy of the proximal tibia hemicallotasis. J Bone Joint Surg Br. 2001;83:1111-1115.
95. Magyar G, Ahl TL, Vibe P, et al. Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations. J Bone Joint Surg Br. 1999;81:444-448.
96. Adili A, Bhandari M, Giffin R, et al. Valgus high tibial osteotomy. Comparison between an Ilizarov and a Coventry wedge technique for the treatment of medial compartment osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2002;10:169-176.
97. Maquet P. Valgus osteotomy for osteoarthritis of the knee. Clin Orthop Relat Res. 1976;120:143-148.
98. Takahashi T, Wada Y, Tanaka M, et al. Dome-shaped proximal tibial osteotomy using percutaneous drilling for osteoarthritis of the knee. Arch Orthop Trauma Surg. 2000;120:32-37.
99. Kessler OC, Jacob HA, Romero J. Avoidance of medial cortical fracture in high tibial osteotomy: improved technique. Clin Orthop Relat Res. 2002;395:180-185.
100. Spahn G. Complications in high tibial (medial opening wedge) osteotomy. Arch Orthop Trauma Surg. 2004;124:649-653.
101. Kirgis A, Albrecht S. Palsy of the deep peroneal nerve after proximal tibial osteotomy. An anatomical study. J Bone Joint Surg Am. 1992;74:1180-1185.
102. Bauer T, Hardy P, Lemoine J, et al. Drop foot after high tibial osteotomy: a prospective study of aetiological factors. Knee Surg Sports Traumatol Arthrosc. 2005;13:23-33.
103. Aydogdu S, Yercan H, Saylam C, et al. Peroneal nerve dysfunction after high tibial osteotomy. An anatomical cadaver study. Acta Orthop Belg. 1996;62:156-160.
104. Georgoulis AD, Makris CA, Papageorgiou CD, et al. Nerve and vessel injuries during high tibial osteotomy combined with distal fibular osteotomy: a clinically relevant anatomic study. Knee Surg Sports Traumatol Arthrosc. 1999;7:15-19.
105. Sawant MR, Ireland J. Pseudo-aneurysm of the anterior tibial artery complicating high tibial osteotomy - a case report. Knee. 2001;8:247-248.
106. Zaidi SH, Cobb AG, Bentley G. Danger to the popliteal artery in high tibial osteotomy. J Bone Joint Surg Br. 1995;77:384-386.
107. Tindall AJ, Shetty AA, James KD, et al. Prevalence and surgical significance of a high-origin anterior tibial artery. J Orthop Surg (Hong Kong). 2006;14:13-16.
108. Smith PN, Gelinas J, Kennedy K, et al. Popliteal vessels in knee surgery. A magnetic resonance imaging study. Clin Orthop Relat Res. 1999;367:158-164.
109. Hee HT, Low CK, Seow KH, et al. Comparing staple fixation to buttress plate fixation in high tibial osteotomy. Ann Acad Med Singapore. 1996;25:233-235.
110. Warden SJ, Morris HG, Crossley KM, et al. Delayed- and non-union following opening wedge high tibial osteotomy: surgeons' results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc. 2005;13:34-37.
111. Tjornstrand B, Hagstedt B, Persson BM. Results of surgical treatment for non-union after high tibial osteotomy in osteoarthritis of the knee. J Bone Joint Surg Am. 1978;60:973-977.
112. Tsumaki N, Kakiuchi M, Sasaki J, et al. Low-intensity pulsed ultrasound accelerates maturation of callus in patients treated with opening-wedge high tibial osteotomy by hemicallotasis. J Bone Joint Surg Am. 2004;86-A:2399-2405.
113. Turner RS, Griffiths H, Heatley FW. The incidence of deep-vein thrombosis after upper tibial osteotomy. A venographic study. J Bone Joint Surg Br. 1993;75:942-944.
114. Motycka T, Eggerth G, Landsiedl F. The incidence of thrombosis in high tibial osteotomies with and without the use of a tourniquet. Arch Orthop Trauma Surg. 2000;120:157-159.
115. Gibson MJ, Barnes MR, Allen MJ, et al. Weakness of foot dorsiflexion and changes in compartment pressures after tibial osteotomy. J Bone Joint Surg Br. 1986;68:471-475.
116. Marti CB, Jakob RP. Accumulation of irrigation fluid in the calf as a complication during high tibial osteotomy combined with simultaneous arthroscopic anterior cruciate ligament reconstruction. Arthroscopy. 1999;15:864-866.
117. Noyes FR, Barber-Westin SD, Hewett TE. High tibial osteotomy and ligament reconstruction for varus angulated anterior cruciate ligament-deficient knees. Am J Sports Med. 2000;28:282-296.
118. Boss A, Stutz G, Oursin C, et al. Anterior cruciate ligament reconstruction combined with valgus tibial osteotomy (combined procedure). Knee Surg Sports Traumatol Arthrosc. 1995;3:187-191.
119. Neuschwander DC, Drez D Jr, Paine RM. Simultaneous high tibial osteotomy and ACL reconstruction for combined genu varum and symptomatic ACL tear. Orthopedics. 1993;16:679-684.
120. Noyes FR, Barber SD, Simon R. High tibial osteotomy and ligament reconstruction in varus angulated, anterior cruciate ligament-deficient knees. A two- to seven-year follow-up study. Am J Sports Med. 1993;21:2-12.