Slope Osteotomies in the Setting of Anterior Cruciate Ligament Deficiency.
J Bone Joint Surg Am
; 106(17): 1615-1628, 2024 Sep 04.
Article
en En
| MEDLINE
| ID: mdl-39066689
ABSTRACT
⤠Posterior tibial slope (PTS) of ≥12° represents an important risk factor for both anterior cruciate ligament (ACL) injury and ACL reconstruction failure.⤠PTS measurements can significantly differ on the basis of the imaging modality and the measurement technique used. PTS should be measured on strictly lateral radiographs, with a recommended proximal tibial length of 15 cm in the image. The PTS measurement can be made by placing 2 circles to define the proximal tibial axis, 1 just below the tibial tubercle and another 10 cm below it. PTS measurements are underestimated when made on magnetic resonance imaging and computed tomography.⤠Slope-reducing osteotomies can be performed using a (1) supratuberosity, (2) tubercle-reflecting transtuberosity, or (3) infratuberosity method. The correction target remains a topic of debate. Although it is controversial, some authors recommend overcorrecting the tibial slope slightly to a range of 4° to 6°. For instance, if the initial slope is 12°, a correction of 6° to 8° should be performed, given the target tibial slope of 4° to 6°.⤠Clinical outcomes following slope-reducing osteotomies have been favorable. However, potential complications, limited data with regard to the impact of slope-reducing osteotomies on osteoarthritis, and uncertainty with regard to the effects on the patellofemoral joint are notable concerns.⤠Patients with complex deformities may need biplanar osteotomies to comprehensively address the condition.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Osteotomía
/
Tibia
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Reconstrucción del Ligamento Cruzado Anterior
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Lesiones del Ligamento Cruzado Anterior
Límite:
Humans
Idioma:
En
Revista:
J Bone Joint Surg Am
/
J. bone jt. sur. Ser. A, Am. vol
/
Journal of bone and joint surgery
Año:
2024
Tipo del documento:
Article