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The Journal of Knee Surgery Reports 2015; 1(01): 051-056
DOI: 10.1055/s-0035-1551548
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anterior Closing Wedge Tibial Osteotomy for Failed Anterior Cruciate Ligament Reconstruction

Justin Walker
1   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
David Hartigan
1   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Michael Stuart
1   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Aaron Krych
1   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

08 May 2014

09 March 2015

Publication Date:
01 June 2015 (online)

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Abstract

The success rate for achieving knee stability in primary anterior cruciate ligament (ACL) reconstruction is high; however, the results of revision reconstruction are less satisfactory. Sagittal plane malalignment is an uncommon predisposing factor for failure because excessive posterior tibial slope increases stress on the ACL graft. In carefully selected patients, tibial slope correction is an essential adjunctive procedure to achieve a stable knee. We present a case report outlining the surgical technique for correction of sagittal plane imbalance by a slope-decreasing anterior closing wedge tibial osteotomy combined with a second-stage revision ACL reconstruction. At 2 years following surgery, our patient had a stable knee and returned to low-impact athletic activity without symptoms. Further investigation is needed to refine the indications for this procedure in the setting of failed ACL reconstruction.

Keywords

deflexion - sagittal plane ACL - ACL revision - anterior closing wedge osteotomy - increased slope
 

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