Editorial Commentary: Too Many Questions Remain to Consider Slope-Correcting Osteotomy for Most Primary Anterior...

Anterior cruciate ligament (ACL) reconstructions and meniscus repairs can have unacceptably high retear rates among certain cohorts of young athletes. Studies have showed that increased posterior tibial slopes are associated with increased risk of ACL and meniscus retears. Increasing evidence suggests that slope-correcting osteotomy can decrease retear rates following ACL reconstructions and meniscus tears in certain populations. However, preventing ACL graft failures and meniscus retears at all costs should not be the only consideration: risk of major complications and reoperations, ability to return to work and return to play, and long-term functional outcomes are important barometers to gauge the success or failure of a procedure. These outcomes need to be further clarified prior to readily adopting slope-correcting osteotomy in most athletes undergoing primary ACL reconstruction.