The Role of Osteotomy in Anterior Cruciate Ligament Reconstruction

Abstract

Coronal and sagittal plane knee malalignments have been shown to increase the forces on anterior cruciate ligament (ACL) grafts after ACL reconstruction (ACLR). Studies have shown the benefit of high tibial osteotomy to address coronal and sagittal imbalance in revision ACLR. The purpose of this article is to further describe the use of osteotomy by reviewing preoperative planning, indications, techniques, and outcomes of high tibial opening and closing wedge as well as anterior tibial closing wedge osteotomies in the setting of ACLR.

Keywords: ACL reconstruction (ACLR); Anterior closing wedge osteotomy; Coronal and sagittal plane malalignment; Lateral closing wedge high tibial osteotomy; Medial opening wedge high tibial osteotomy; Revision.