ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
First revision ACL reconstruction combined with tibial deflexion osteotomy improves clinical scores at 2 to 7 years follow-up.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Slope-reducing tibial osteotomy combined with primary or revision ACL reconstruction improves knee stability and subjective function in patients with steep posterior tibial slope: a systematic review and meta-analysis.International journal of surgery (London, England) · 2026Pooled it
- Combined anterior cruciate ligament revision with reconstruction of the antero-lateral ligament does not improve outcome at 2-year follow-up compared to isolated acl revision; a randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Trial
- Management of increased posterior tibial slope in ACL deficiency: A narrative review and recommendation of the Osteotomy Committee of the German Knee Society.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Review
- A simple planning tool for tibial slope osteotomy-Osteotomy depth is a precise parameter to determine wedge height.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Slope-reducing tibial osteotomy yields better posterior horn healing performance of longitudinal and bucket-handle tears of medial meniscus in patients undergoing ACL reconstruction: a minimum 2-year follow-up study with second-look arthroscopy.Journal of orthopaedic surgery and research · 2026Article
- #KneeOsteotomy: Evaluation of the Quality and Educational Value of TikTok Videos.Orthopaedic journal of sports medicine · 2026Article
- Technical tips and tricks for complex biplanar high tibial osteotomies.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Review
- Individualized indication for slope changing osteotomy in ACL insufficiency: the Avalanche Concept.Archives of orthopaedic and trauma surgery · 2025Article
- Article
- Revision anterior cruciate ligament reconstruction and additional surgeries: A review.Medicine · 2025Review
- Infratuberositary slope-decreasing anterior closed wedge proximal tibial osteotomy is safe and shows rapid bone healing.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Axial rotation of the hinge axis can cause changes in coronal tibial alignment in anterior tibial closing wedge osteotomy in a 3D simulation model.Journal of experimental orthopaedics · 2025Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo report outcomes of first revision anterior cruciate ligament reconstruction (ACLR) with tibial deflexion osteotomy (TDO) in patients with posterior tibial slope (PTS) >10° at >2 years.
methodsThe authors studied outcomes of a consecutive series of 16 patients that underwent first revision ACLR with TDO, including Lysholm score, IKDC subjective and objective scores, Lachman test, PTS, and signs of osteoarthritis. One woman was excluded because of early signs of knee arthritis, as the first revision ACLR took place 27 years following the primary ACLR. This left a final cohort of 15 patients assessed at minimum follow-up of 2 years.
resultsThe final cohort comprised 14 men and 1 woman aged 25.3 ± 6.6 years (range 16-39) at first revision ACLR. At final follow-up of 4.4 ± 1.5 years (range, 2-7), PTS was corrected from 12.5 ± 1.8° (range 8-15°) to 1.9 ± 3.6° (range - 4 to 8°), and none of the knees had radiographic signs of osteoarthritis. Lysholm score was 83.8±12.5, IKDC subjective score was 80.3±16.2, and IKDC objective score was A in 5 (33%), and B in 10 (67%). The net improvement exceeded the minimal clinically important difference (MCID) in 93% of patients for the IKDC subjective score and in 80% of patients for the Lysholm score. None of the knees had any retears, and only one required a reoperation to re-suture a medial meniscal tear due to trauma.
conclusionAt 2-7 years following revision ACLR combined with TDO, net improvement exceeded the MCID in 93% of patients for IKDC subjective score and in 80% of patients for Lysholm score, with no retears or major complications. These results suggest that TDO is a safe technique to protect the ACL graft and might be considered as of first revision ACLR to correct excessive PTS. LEVEL OF EVIDENCE: Level IV.
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