Ganokroj Phob, Peebles Annalise M, Mologne Mitchell S, Foster Michael J, Provencher Matthew T
Steadman Clinic, Vail, Colorado, USA.
Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
Arthrosc Tech. 2022 Oct 20;11(11):e1989-e1995. doi: 10.1016/j.eats.2022.07.015. eCollection 2022 Nov.
Failure of anterior cruciate ligament reconstruction (ACLR) remains a challenging problem. Recently, the effect of increased posterior tibial slope has been identified as a risk factor for ACLR failure. In cases with increased posterior tibial slope, an anterior closing wedge, slope-correcting high tibial osteotomy can be used as a robust adjunct to revision ACLR. In this Technical Note, we demonstrate our preferred method for isolated sagittal plane correction following multiple failed ACLRs with an anterior closing-wedge high tibial osteotomy technique using 3-dimensional patient-specific instrumentation. Through correction of the angular deformity and restoration of the defined sagittal slope via the use of advanced 3-dimensional patient-specific instrumentation, this technique fosters an accurate, favorable mechanical environment to prevent recurrent instability of the knee joint.
前交叉韧带重建（ACLR）失败仍然是一个具有挑战性的问题。最近，胫骨后倾增加的影响已被确定为ACLR失败的一个风险因素。在胫骨后倾增加的病例中，前闭合楔形、坡度矫正高位胫骨截骨术可作为翻修ACLR的有力辅助手段。在本技术说明中，我们展示了我们首选的方法，即使用三维患者特异性器械，采用前闭合楔形高位胫骨截骨术，对多次ACLR失败后的矢状面进行单独矫正。通过使用先进的三维患者特异性器械矫正角度畸形并恢复确定的矢状坡度，该技术营造了一个准确、良好的力学环境，以防止膝关节反复出现不稳定。
