Unstable osteoarthritis genu varum. Our experience

BACKGROUND: The natural evolution of chronic anterior cruciate ligament (ACL) failure is the progressive deterioration of articular cartilage of the knee, which consequences are the arthrosis and the secondary misalignment. This is an increasingly common in middle-aged patients (30-50 years). Also, these patients are demanding reinstatement expectation of sporting activity, claiming that refund promptly and at the same level prior to the injury. OBJECTIVES: Communicate the experience in our service, of treatment implement in young adults patients with misalignment., osteoarthritis and instability anteroposterior; describe the algorithm used and technique surgical. Study desing: Case study series; level of evidence 3. METHODS: Series case study, retrospective. There were 15 valgus osteotomies additive of tibia with plastic ligaments of anterior cruciate ligament (in a same time surgical) in the period between 2014 and 2015. RESULTS: Average monitoring of 8 months. The following parameters were evaluated pre and postoperative: pain (EVA 3.06 / 0.8), instability (Lachman 1.4 / 0.6), Score of Lysholm (83.9 / 108/5), thigh circumference (-0.13 cm / -1.86 cm) and range of motion (flexion and extension). CONCLUSION: The instability on knees with misalignment, increases progression of osteoarthritis. The presence of pain, misalignment and instability, will guide the therapeutic indication. If we make an indicated process (osteotomy and ACL) in the indicated time and in the indicated patient, we can get as excellent results like in our series, delaying the natural progression of the arthrosis. In this way, we increase the expectations of return to practice recreational sports of our patients.