Anterior Closing-Wedge High Tibial Slope-Correcting Osteotomy Using Patient-Specific Preoperative Planning Software for Failed Anterior Cruciate Ligament Reconstruction

Phob Ganokroj; Annalise M Peebles; Mitchell S Mologne; Michael J Foster; Matthew T Provencher

doi:10.1016/j.eats.2022.07.015

Anterior Closing-Wedge High Tibial Slope-Correcting Osteotomy Using Patient-Specific Preoperative Planning Software for Failed Anterior Cruciate Ligament Reconstruction

Arthrosc Tech. 2022 Oct 20;11(11):e1989-e1995. doi: 10.1016/j.eats.2022.07.015. eCollection 2022 Nov.

Authors

Phob Ganokroj^{1

2}, Annalise M Peebles³, Mitchell S Mologne³, Michael J Foster¹, Matthew T Provencher^{1

3}

Affiliations

¹ Steadman Clinic, Vail, Colorado, USA.
² Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
³ Steadman Philippon Research Institute, Vail, Colorado, USA.

Abstract

Failure of anterior cruciate ligament reconstruction (ACLR) remains a challenging problem. Recently, the effect of increased posterior tibial slope has been identified as a risk factor for ACLR failure. In cases with increased posterior tibial slope, an anterior closing wedge, slope-correcting high tibial osteotomy can be used as a robust adjunct to revision ACLR. In this Technical Note, we demonstrate our preferred method for isolated sagittal plane correction following multiple failed ACLRs with an anterior closing-wedge high tibial osteotomy technique using 3-dimensional patient-specific instrumentation. Through correction of the angular deformity and restoration of the defined sagittal slope via the use of advanced 3-dimensional patient-specific instrumentation, this technique fosters an accurate, favorable mechanical environment to prevent recurrent instability of the knee joint.