II.

Purpose The goal of this article was to present the clinical and radiological results of 42 severe genu varum operated on between August 2001 and June 2010 using computer navigation. Methods All the osteotomies were navigated using the Orthopilot® device (B-Braun-Aesculap, Tuttlingen, Germany). The procedure was performed such that after inserting the rigid bodies and calibrating the lower leg, we first made the femoral closing wedge osteotomy (from four to seven mm) which was fixed by an AO T-Plate, and then, after checking the residual varus, the tibial opening wedge osteotomy was made using a Biosorb® wedge (Tricalcium phosphate, SBM, Lourdes, France) and a plate (AO T-plate or C-plate). Results All the patients were assessed at a mean followup of 46 ± 27 months (range, 12-108). The mean Lyshölm-Tegner score was 83.3± 7.5 points (62-91) and the mean KOOS score was 95.1±3.2 points (89-100). Forty patients were satisfied (22) or very satisfied (18) with the result. Regarding the radiological results, the goal was reached in 92.7% of cases and the mean HKA angle was 181.83°±1.80°(177-185°). At that mid-term follow-up no patient had revision to a total knee arthroplasty. Conclusion Computer-assisted double level osteotomy in severe genu varum is a reliable, reproducible, and accurate technique. This procedure, which is very delicate, especially in reaching pre-operative objectives, is simplified by computer-assistance.

Early operative treatment by means of the quadruple hamstring free graft appears to be a safe and relevant procedure for ACL reconstruction even in skeletally immature patients.

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