Z Orthop Unfall 2020; 158(05): 532-533
DOI: 10.1055/a-1200-2910
Videopaper

Tibial Slope Correction as an Infratuberosity Closing-Wedge Extension Osteotomy in ACL-Deficient Knees

Article in several languages: English | deutsch
Jörg Dickschas
1   Department for Orthopaedic and Trauma Surgery, Sozialstiftung Bamberg
,
Michael J. Strobel
2   Orthopaedic Surgery, Sportopaedicum Straubing
,
Andreas Weiler
3   Orthopaedic Surgery, Sportopaedicum Berlin
,
Philipp Lobenhoffer
4   Orthopaedic Surgery, go:h Orthopaedic Joint Surgery Hanover
,
Michael Simon
5   Department for Orthopaedic and Trauma Surgery, am Bruderwald Hospital, Bamberg
› Author Affiliations

Abstract

ACL insufficiency can be caused by different reasons. Elevated posterior tibial slope is a deformity which is discussed to have relevant influence on the outcome of ACL surgery. A increased posterior tibial slope of 12° or more leads to significant more ACL insufficiency. The surgical therapy of this pathology is a high tibial extension osteotomy. Publications ashowing a clinical follow up and results of this surgery are rare. In this video the technique of a closed wedge high tibial extension osteotomy is shown. Osteosynthesis is performed with two screws and an anklestable plate osteosynthesis. An arthroscopy with bone graft filling of the femoral ACL tunnel is performed first, followed by filling of the tibial tunnel in an open approach.



Publication History

Article published online:
24 August 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 
  • References/Literatur

  • 1 Southam BR, Colosimo AJ, Grawe B. Underappreciated factors to consider in revision anterior cruciate ligament reconstruction: a current concepts review. Orthop J Sports Med 2018; 6: 2325967117751689
  • 2 Salmon LJ, Heath E, Akrawi H. et al. 20-year outcomes of anterior cruciate ligament reconstruction with hamstring tendon autograft: the catastrophic effect of age and posterior tibial slope. Am J Sports Med 2018; 46: 531-543
  • 3 Dejour H, Bonnin M. Tibial translation after anterior cruciate ligament rupture. Two radiological tests compared. J Bone Joint Surg Br 1994; 76: 745-749
  • 4 Sonnery-Cottet B, Mogos S, Thaunat M. et al. Proximal tibial anterior closing wedge osteotomy in repeat revision of anterior cruciate ligament reconstruction. Am J Sports Med 2014; 42: 1873-1880
  • 5 DePhillipo NN, Kennedy MI, Dekker TJ. et al. Anterior closing wedge proximal tibial osteotomy for slope correction in failed ACL reconstructions. Arthrosc Tech 2019; 8: e451-e457
  • 6 Dejour D, Saffarini M, Demey G. et al. Tibial slope correction combined with second revision ACL produces good knee stability and prevents graft rupture. Knee Surg Sports Traumatol Arthrosc 2015; 23: 2846-2852
  • 7 Hees T, Petersen W. Anterior Closing-Wedge Osteotomy for Posterior Slope Correction. Arthrosc Tech 2018; 7: :e1079-e1087