SynthesisInternational journal of surgery (London, England)2026
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.
Synthesis in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- What does a failure in anterior cruciate ligament reconstruction really mean? An integrative view.Knee surgery & related research · 2026Review
- A Research Hotspot-Guided Meta-Analysis of Anterior Closing-Wedge High Tibial Osteotomy in Revision Anterior Cruciate Ligament Reconstruction.Bioengineering (Basel, Switzerland) · 2026Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo systematically review and quantitatively analyze the clinical outcomes of slope-reducing tibial osteotomy combined with anterior cruciate ligament (ACL) reconstruction (ACLR) in patients with steep posterior tibial slope (PTS).
methodsThis study was performed in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines. PubMed, Embase, Web of Science, and Scopus databases were searched to identify studies reporting clinical outcomes of slope-reducing tibial osteotomy in ACL reconstruction patients with steep PTS. Data on patient-reported outcome measures, radiological parameters, knee stability as revealed by pivot shift grade, and knee anterior laxity and complications were extracted based on the inclusion criteria. The Methodological Index for Non-Randomized Study (MINORS) score was used for quality assessment. Review Manager and R statistical software were used to perform the statistical analysis.
resultsNine studies with a total of 227 knees in 91 primary and 136 revision ACLR patients were included. Nearly 60% of patients experienced ≥2 revision ACLR. In revision ACLR, the currently well-accepted indication for slope-reducing osteotomy is a slope >12° (measured on the short-segment radiographs). Primary ACLR patients with a more stringent slope (≥16°, measured on weight-bearing full-length radiographs), excessive anterior tibial translation (≥6 mm), or poor meniscus status may benefit from additional osteotomy. After combined procedures, substantial decreases were detected in the proportion of knees with pivot shift grades II-III [71/121 (58.7%) vs 19/121 (15.7%); OR = 23; P = 0.003] and side-to-side differential anterior laxity (weighted mean: 8.0 vs 1.9, weighted mean difference = 6.1, P < 0.00001). Significant improvements ( P < 0.00001) were identified in the Lysholm score (weighted mean: 47 vs 82.9) and International Knee Documentation Committee score (weighted mean: 39.3 vs 71.7). The incidence of adverse events after osteotomy ranged from 0% to 39.1% with an overall pooled rate of 10.6% (95% confidence interval = 0.5%-20.7%). Hardware discomfort and graft re-rupture with high-grade pivot shift were common complications. No patients experienced surgical site infection or bone nonunion.
conclusionCombined slope-reducing tibial osteotomy demonstrates significant improvements in both knee stability and patient-reported outcomes for revision ACLR. Similarly, primary ACLR patients with steep PTS, excessive anterior tibial translation, and poor meniscus status may derive clinical benefits from additional osteotomy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.