Editorial Commentary: Concomitant Anterior Closing Wedge High Tibial Osteotomy Should Be Considered to Protect the Graft After Primary Anterior Cruciate Ligament Reconstruction for Patients With a Posterior Tibial Slope More Than 12° and Anterior Tibial Translation More Than 5 mm.

Abstract

A posterior tibial slope ≥12° at the time of primary anterior cruciate ligament reconstruction is a challenging situation, especially when combined with a static anterior tibial translation >5 mm. Either the use of a bone-patellar tendon-bone graft or the addition of a lateral extra-articular tenodesis at the time of primary anterior cruciate ligament reconstruction may provide insufficient protection for the graft in patients with an increased posterior tibial slope. Anterior closing wedge high tibial osteotomy may be considered to protect the graft after primary anterior cruciate ligament reconstruction for patients with a posterior tibial slope ≥12°. However, further evidence is required to determine whether concomitant anterior closing wedge high tibial osteotomy significantly reduces the graft failure rate.