Supratubercle Anterior Closing Wedge Osteotomy: No Changes in Patellar Height and Significant Decreases in Anterior Tibial Translation at 6 Months Postoperatively.

BACKGROUND

Because of the increased prevalence of revision anterior cruciate ligament (ACL) reconstruction, there has been a desire to understand the role of posterior tibial slope on increased anterior tibial translation and increased ACL graft forces. One potential concern in supratubercle anterior closing wedge proximal tibial osteotomy (ACW-PTO) for decreasing the posterior tibial slope is the risk of altering the patellar height.

PURPOSE

To radiographically assess changes in (1) patellar height, (2) anterior tibial translation, and (3) posterior tibial slope after supratubercle ACW-PTO.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Patients who underwent supratubercle ACW-PTO by a single surgeon between July 2019 and June 2023 were included. Standardized lateral knee weightbearing radiographs to assess patellar height (via the Caton-Deschamps index), anterior tibial translation of the lateral tibial plateau relative to the lateral femoral condyle, and posterior tibial slope were obtained at 4 time points (preoperatively and 1 day, 3 months, and 6 months postoperatively). Paired

RESULTS

In 20 patients after ACW-PTO, the Caton-Deschamps index demonstrated a significant increase in patellar height on postoperative day 1 (

CONCLUSION

Supratubercle ACW-PTO performed for ACL reconstruction failure in the setting of an increased posterior tibial slope did not induce significant changes in patellar height postoperatively. Furthermore, after ACW-PTO, there was a significant decrease in anterior tibial translation and posterior tibial slope.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: N.I.K. has received support for education from Foundation Medicine and Smith & Nephew and hospitality payments from Zimmer Biomet and Encore Medical. C.A.W. has ownership and investment interest in Responsive Arthroscopy and has received speaking fees from Smith & Nephew. C.M.L. has received speaking fees from Smith & Nephew and Synthes and consulting fees from Smith & Nephew and Responsive Arthroscopy. R.F.L. has received consulting fees from Ossur, Smith & Nephew, and Responsive Arthroscopy; royalties from Ossur, Smith & Nephew, Elsevier, and Arthrex; research support from Ossur and Smith & Nephew; and support for education from Foundation Medicine. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.