BACKGROUND: Concomitant high tibial osteotomy (HTO) and anterior cruciate ligament (ACL) reconstruction is a combined surgical procedure intended to improve kinematics and kinetics in the unstable ACL-deficient knee with @entity893 and medial compartment knee @entity571 ( @entity571 ). PURPOSE: To investigate 5-year changes in gait biomechanics as well as radiographic and @entity1 -reported outcomes bilaterally after unilateral, concomitant medial opening wedge HTO and ACL reconstruction. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 33 @entity1 (mean    SD age, 40    9 years) with @entity893 (mean mechanical axis angle, -5.9      2.9  ), medial compartment knee @entity571 , and @entity1347 completed 3-dimensional gait analysis preoperatively and 2 and 5 years postoperatively. Primary outcomes were the peak external knee adduction (first peak) and flexion moments. Secondary outcomes were the peak external knee extension and transverse plane moments, peak knee angles in all 3 planes, radiographic static knee alignment measures (mechanical axis angle and posterior tibial slope), and the @entity3331 and @entity571 Outcome Score (KOOS). RESULTS: There was a substantial decrease in the knee adduction moment in the surgical limb (%BW * @entity8108 , -1.49; 95% CI, -1.75 to -1.22) and a slight increase in the nonsurgical limb (%BW * @entity8108 , 0.16; 95% CI, 0.03 to 0.30) from preoperatively to 5 years postoperatively. There was also a decrease in the knee flexion moment for both the surgical (%BW * @entity8108 , -0.67; 95% CI, -1.19 to -0.15) and nonsurgical limbs (%BW * @entity8108 , -1.06; 95% CI, -1.49 to -0.64). Secondary outcomes suggested that substantial improvements were maintained at 5 years, although smaller declines were observed in several measures and in both limbs from 2 to 5 years. CONCLUSION: Changes in the peak external moments about the knee in all 3 planes during walking were observed 5 years after concomitant medial opening wedge HTO and ACL reconstruction. These findings are consistent with an intended, sustained shift in the mediolateral distribution of knee loads. CLINICAL RELEVANCE: These findings suggest that concomitant HTO and ACL reconstruction results in substantial changes in gait biomechanics. Future clinical research comparing treatment strategies is both warranted and required for this relatively uncommon but seemingly biomechanically efficacious procedure.

Five-Year Changes in Gait Biomechanics After Concomitant High Tibial Osteotomy and ACL Reconstruction in XXXX With Medial Knee Osteoarthritis.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity571 :: ('MESH:D010003', 'Disease') :: ['osteoarthritis', 'OA', 'Osteoarthritis'] @entity1347 :: ('MESH:C537775', 'Disease') :: ['ACL deficiency'] @entity3331 :: ('MESH:D007718', 'Disease') :: ['Knee injury'] @entity8108 :: ('D006859', 'Chemical') :: ['H'] @entity893 :: ('MESH:D017760', 'Disease') :: ['varus malalignment']
@entity1 :: (9606,Species) :: ['Patients']
