Tibial Tubercle Preserving Anterior Closing Wedge Proximal Tibial Osteotomy and ACL Tunnel Bone Grafting for Increased Posterior Tibial Slope in Failed ACL Reconstructions
Edward R. Floyd, Gregory B. Carlson, Jill K. Monson, Robert F. LaPrade
Abstract
Anterior cruciate ligament reconstruction (ACLR) failure is multifactorial, but it is known that increased posterior tibial slope (PTS) leads to a greater likelihood of ACLR failure. This technical note describes the senior author's technique for performing an anterior closing wedge proximal tibial osteotomy, in which the osteotomy is made proximal to the tibial tubercle. This procedure is the first part of a staged surgery for patients with multiple failed ACLRs and increased sagittal plane PTS. Debridement of osteolytic reconstruction tunnels with bone grafting is also undertaken in preparation for a second-stage revision ACLR.
Topics & Concepts
MedicineHigh tibial osteotomyAnterior cruciate ligament reconstructionSurgerySagittal planeOsteotomyBone graftingAnterior cruciate ligamentOsteoarthritisAnatomyAlternative medicinePathologyKnee injuries and reconstruction techniquesTotal Knee Arthroplasty OutcomesLower Extremity Biomechanics and Pathologies