Infratubercle Anterior Closing Wedge Osteotomy Corrects Sagittal Alignment without Affecting Coronal Alignment or...

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Radiology

Background:

• Excessive posterior tibial slope (PTS) increases graft failure risk after anterior cruciate ligament reconstruction (ACLR).
• Anterior closing wedge osteotomy (ACWO) can correct PTS but may affect coronal alignment and patellar height.

Purpose of the Study:

• To evaluate radiological outcomes of infratubercle ACWO combined with ACLR.
• Specifically assess the influence of infratubercle ACWO on perioperative patellar height changes.

Main Methods:

• Included patients undergoing infratubercle ACWO with ACLR for PTS > 12°.
• Radiological assessment included hip-knee-ankle angle (HKA), PTS, femoral patellar height index (FPHI), and Caton-Deschamps index (CDI) pre- and postoperatively.
• Knee recurvatum was measured preoperatively and at final follow-up.

Main Results:

• Significant PTS correction achieved (14.5° to 5.7°, p < 0.001) with no significant HKA change.
• No significant change in FPHI or patellar height categories observed.
• Knee recurvatum significantly increased (4.9° to 7.8°, p < 0.001).

Conclusions:

• Infratubercle ACWO provides precise sagittal correction for PTS without altering coronal alignment or patellar height.
• The procedure is effective in managing excessive PTS in ACLR patients.