Simultaneous opening-wedge distal tubercle osteotomy and double-bundle anterior cruciate ligament reconstruction for anterior cruciate ligament-deficient knees with medial compartment osteoarthritis: technical tip

The surgical outcomes of simultaneous anterior cruciate ligament reconstruction (ACLR) and high tibial osteotomy (HTO) are good in ACL-deficient knees with medial compartment osteoarthritis (OA). However, this procedure has issues to be solved, such as mild knee instability and progression of OA after surgery. Herein, we introduce our surgical procedure and technical tip of opening-wedge distal tubercle osteotomy (OWDTO) performed simultaneously with anatomical double-bundle ACLR (DBACLR). This procedure aims to achieve long-term knee stability by anatomically reconstructing the ACL using the double-bundle technique even though ACLR and OWDTO are both performed for ACL-deficient knees with medial compartment OA.