Most of our middle-aged patients with varus osteoarthritic knees and anterior cruciate ligament deficiencies have been treated conservatively. A small number of those patients complained of subse-quent instability and medial joint pain. Three patients (a woman and two men) who had vigorous physical activity were treated with one-stage operation of anterior cruciate ligament reconstruction and open wedge high tibial osteotomy using rigid internal fixation. The follow-up period ranged from 1.5 to 2.3 years, with a mean of 1.7 years. The mean preoperative JOA score for those osteoarthritic knees was 72 points, which was increased to 95 at the follow-up. The mean preoperative Lysholm knee score was 35 points; the mean follow-up Lysholm score increased to 89. At follow-up, all patients reported no instability and no medial joint pain.
