Infratubercle Anterior Closing-Wedge Slope–Reducing Osteotomy in Revision ACL Reconstruction: Technical Pearls and Radiographic Results - 10/11/26
, Paul Laidet a, b, Julien Druel a, b, Romir Patel c, Matthieu Ollivier a, bAbstract |
Introduction |
Increased posterior tibial slope (PTS) increases the risk of anterior cruciate ligament (ACL) graft failure. Infratubercle anterior closing-wedge slope–reducing osteotomy (ACW-SRO) preserves the tibial tubercle and allows simultaneous ACL revision.
Purpose |
This technical note outlines the surgical steps and short-term radiographic outcomes of combined ACW-SRO and ACL revision.
Methods |
Forty-six patients (mean age 24, BMI 23) with PTS ≥12 ° underwent surgery between January 2022 and December 2023. The osteotomy was performed 2 cm below the tibial tubercle, fixed with a locking plate and screw, and ACL tunnels were drilled after fixation. Postoperative care included partial weightbearing for 3 weeks and bracing in –10 ° extension.
Results |
PTS improved from 76 ° to 85 ° (p < 0.001), with a mean correction of 9 °. Coronal alignment was preserved (p = 0.12). All osteotomies healed within 4 months. One superficial infection (2%) and one screw backout (2%) occurred; no hinge fracture, nonunion, or hardware failure was observed.
Level of evidence |
IV; Retrospective case series.
Le texte complet de cet article est disponible en PDF.Keywords : ACL revision, Slope correction, Infratubercle osteotomy, Anterior closing-wedge, Posterior tibial slope, High tibial osteotomy
Plan
Vol 112 - N° 7
Article 104548- février 2026 Retour au numéro
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