Anterior Open-Wedge Osteotomy in Posterior Cruciate Ligament Deficient Knees: From a Historical Perspective to First Clinical Results

J Knee Surg DOI: 10.1055/s-0041-1723983Recently, the bony anatomy of the proximal tibia has gained strong interest, particularly in the cruciate ligament deficient knee. Regarding the anterior cruciate ligament (ACL), several studies outlined that a steep tibial slope (≥12 degrees) contributes to early failures after ACL reconstruction. As a consequence, the first clinical reports are available on slope reducing osteotomies in revision ACL surgery. Vice versa, biomechanical as well as clinical reports suggest that a flat slope increases the load on the posterior cruciate ligament (PCL) and might contribute to a poor result after PCL reconstruction. Since many decades, slope increasing anterior open wedge osteotomies are used to treat a symptomatic genu recurvatum. The aim of the current report is to describe different surgical techniques and report our first clinical experience of an anterior open wedge osteotomy as a sole procedure in chronic PCL deficient knees with a flat tibial slope. In six cases, a mean preoperative slope of 3.7 degrees (range = 2–5 degrees) was increased to a mean of 11.5 degrees (range = 9–13 degrees). There was one case with a delayed bone healing, which was successfully treated without loss of correction by revision internal fixation and bone grafting. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Special Section Article Source Type: research