Slope-Reducing High Tibial Osteotomy and Over-The-Top Anterior Cruciate Ligament Reconstruction With Achilles Tendon Allograft in Multiple Failed Anterior Cruciate Ligament Reconstruction

Zsidai B., ÖZBEK E. A., Engler I. D., Kaarre J., Nazzal E. M., Curley A. J., ...Daha Fazla

Arthroscopy Techniques, cilt.11, sa.11, 2022 (ESCI) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 11 Sayı: 11
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.eats.2022.07.019
  • Dergi Adı: Arthroscopy Techniques
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, Directory of Open Access Journals
  • Ankara Üniversitesi Adresli: Hayır

Özet

© 2022 The AuthorsGraft failure is a challenging complication following anterior cruciate ligament reconstruction (ACL-R). Among the multiple anatomic and nonanatomic risk factors contributing to ACL-R failure, there is accumulating evidence that a posterior tibial slope of 12° or greater may predispose patients to graft failure of primary and revision ACL-R. In addition, previously malpositioned or widened tunnels, as well as limited autograft options, pose challenges in the setting of revision ACL-R. This Technical Note describes a technique to correct an increased posterior tibial slope using slope-reducing high tibial osteotomy, and single stage revision ACL-R with Achilles tendon allograft using the over-the-top route, in a single-stage procedure. The surgical technique involves an anterior approach to the proximal tibia, followed by tibial tubercle osteotomy and anterior closing-wedge osteotomy. The posterior cortical osteotomy hinge is left intact below the insertion of the posterior cruciate ligament. Over-the-top revision ACL-R is then performed using an Achilles tendon allograft passed around the posterior aspect of the lateral femoral condyle and fixed onto the lateral femur.