Tibial Tubercle-Sparing Anterior Closing Wedge Osteotomy With Cross-Screw Fixation to Correct Pathologic Posterior Tibial Slope

Cpt Christian A Cruz; Cpt Mitchell C Harris; Cpt Jeffery L Wake; Cpt Gregory E Lause; Brian J Mannino; Craig R Bottoni

doi:10.1016/j.eats.2020.11.005

Tibial Tubercle-Sparing Anterior Closing Wedge Osteotomy With Cross-Screw Fixation to Correct Pathologic Posterior Tibial Slope

Arthrosc Tech. 2021 Feb 22;10(3):e897-e902. doi: 10.1016/j.eats.2020.11.005. eCollection 2021 Mar.

Authors

Cpt Christian A Cruz¹, Cpt Mitchell C Harris¹, Cpt Jeffery L Wake¹, Cpt Gregory E Lause¹, Brian J Mannino¹, Craig R Bottoni¹

Affiliation

¹ Department of Orthopaedic Surgery, Tripler Army Medical Center, Honolulu Hawaii, U.S.A.

Abstract

Anterior cruciate ligament reconstruction failure remains a commonly seen outcome despite advances in technique and graft options. Recent studies have shown that the declination of the tibial plateau slope in the sagittal plane affects the in situ stress on the anterior cruciate ligament. The native posterior tibial slope has been described to range from 7° to 10°. However, several authors have suggested that a posterior tibial slope >12° should be considered pathologic. Given the recent evidence, our institution has begun performing a tibial tubercle-sparing anterior closing wedge proximal tibial osteotomy with cross screw fixation to decrease sagittal plane tibial slope.