Nelson Jessica A, Richter Dustin L, Treme Gehron, Wascher Daniel, Nardin Lisandro, Schenck Robert C
University of New Mexico, Department of Orthopaedics and Rehabilitation, Albuquerque, New Mexico, U.S.A.
Rosario, Argentina.
Arthrosc Tech. 2022 Jul 14;11(8):e1425-e1430. doi: 10.1016/j.eats.2022.03.032. eCollection 2022 Aug.
Excessive posterior tibial slope (PTS) is a recognized risk factor for failure of anterior cruciate ligament reconstruction (ACLR) and should be considered when planning a revision ACLR. A tibial supra-tubercular deflexion osteotomy can correct excessive PTS with simultaneous or staged ACLR. There are only a handful of technical descriptions offering insight on the respective authors' approach at reducing PTS, all of which vary greatly in their methods. The authors describe a surgical technique using a proximal tibial supra-tubercular deflexion osteotomy in patients with persistent knee instability, a history of at least one failed ACLR, and a PTS greater than 12°. This surgery is not recommended in patients with significant genu recurvatum (>10°), significant varus, or severe tibiofemoral osteoarthritis.
胫骨后倾坡度（PTS）过大是前交叉韧带重建（ACLR）失败的一个公认风险因素，在计划进行翻修性ACLR时应予以考虑。胫骨结节上屈曲截骨术可在同期或分期进行ACLR的同时纠正过大的PTS。目前仅有少数技术描述，介绍了各位作者在减少PTS方面的方法，所有这些方法在操作上差异很大。作者描述了一种手术技术，用于治疗持续存在膝关节不稳、至少有一次ACLR失败史且PTS大于12°的患者，采用胫骨近端结节上屈曲截骨术。对于存在明显膝反屈（>10°）、明显内翻或严重胫股骨关节炎的患者，不建议进行该手术。
