Acta Ortopédica Brasileira (Jan 2003)

Valgus osteotomy of the tibia with a Puddu plate combined with anterior cruciate ligament reconstruction

  • Albuquerque Roberto Freire da Mota e,
  • Borges Marcos Cristian,
  • Rocha Milton Luiz da,
  • Akiyama Eduardo Ienny,
  • Aquino Marcos de Amorim,
  • Sasaki Sandra Umeda,
  • Pacheco Alexandre Pagotto,
  • Amatuzzi Marco Martins

Journal volume & issue
Vol. 11, no. 1
pp. 11 – 16

Abstract

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Anterior knee instability associated with a varus deformity is a complex condition with several treatment possibilities. Among these, anterior cruciate ligament (ACL) associated to a simultaneous valgus tibial osteotomy is a increasing indication. This simultaneous procedure adds technical issues to those related to the isolated surgeries. Thus, the osteotomy plane and location of fixation hardware shouldn?t conflict with tibial tunnel and ACL graft fixation. Authors analyze the relations between a opening tibial valgus osteotomy stabilized with a Puddu plate and ACL reconstruction with a patellar tendon graft fixated with interference screws in 10 human cadaver knees. A straight oblique tibial osteotomy starting on the medial tibial cortex and oriented laterally and proximally was performed on all knees with a 10mm opening medially and stabilized with a Puddu plate on the most posterior aspect of the medial tibia, and a tibial tunnel drilled 50° to tibial plateau. With this technique there was no intersection between tibial tunnel or interference screw and the osteotomy or the plate fixation screws.

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