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Anterior Closing-Wedge Osteotomy for Posterior Slope Correction

Increased tibial slope can be a cause of recurrent instability after anterior cruciate ligament reconstruction. This article presents a technique for an anterior closing-wedge osteotomy for slope correction. The indications for this procedure are patients with recurrent instability after anterior cr...

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Detalles Bibliográficos
Autores principales: Hees, Tilman, Petersen, Wolf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261062/
https://www.ncbi.nlm.nih.gov/pubmed/30533352
http://dx.doi.org/10.1016/j.eats.2018.07.003
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author Hees, Tilman
Petersen, Wolf
author_facet Hees, Tilman
Petersen, Wolf
author_sort Hees, Tilman
collection PubMed
description Increased tibial slope can be a cause of recurrent instability after anterior cruciate ligament reconstruction. This article presents a technique for an anterior closing-wedge osteotomy for slope correction. The indications for this procedure are patients with recurrent instability after anterior cruciate ligament reconstruction with a neutral leg axis or slightly varus deformity and a posterior slope of more than 12°. The exposure of the anterior aspect of the tibia is best made through an anterior approach approximately 1 to 2 cm medial to the tibial tuberosity. Hohmann retractors are placed from the medial and lateral sides behind the proximal tibia. The osteotomy lines are marked with 2 converging Kirschner wires with the use of an image intensifier. The entry point of the first Kirschner wire is just below the most inferior fibers of the patellar tendon. The hinge of the osteotomy should be just below the tibial insertion of the posterior cruciate ligament. The osteotomy is performed with an oscillating saw. The posterior cortex of the tibia should be left intact. After removal of the anterior base wedge, the osteotomy is closed by manual pressure. Osteosynthesis is performed with a lag screw from the tibial tuberosity to the distal tibia and an angular stable plate fixator.
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spelling pubmed-62610622018-12-07 Anterior Closing-Wedge Osteotomy for Posterior Slope Correction Hees, Tilman Petersen, Wolf Arthrosc Tech Technical Note Increased tibial slope can be a cause of recurrent instability after anterior cruciate ligament reconstruction. This article presents a technique for an anterior closing-wedge osteotomy for slope correction. The indications for this procedure are patients with recurrent instability after anterior cruciate ligament reconstruction with a neutral leg axis or slightly varus deformity and a posterior slope of more than 12°. The exposure of the anterior aspect of the tibia is best made through an anterior approach approximately 1 to 2 cm medial to the tibial tuberosity. Hohmann retractors are placed from the medial and lateral sides behind the proximal tibia. The osteotomy lines are marked with 2 converging Kirschner wires with the use of an image intensifier. The entry point of the first Kirschner wire is just below the most inferior fibers of the patellar tendon. The hinge of the osteotomy should be just below the tibial insertion of the posterior cruciate ligament. The osteotomy is performed with an oscillating saw. The posterior cortex of the tibia should be left intact. After removal of the anterior base wedge, the osteotomy is closed by manual pressure. Osteosynthesis is performed with a lag screw from the tibial tuberosity to the distal tibia and an angular stable plate fixator. Elsevier 2018-10-01 /pmc/articles/PMC6261062/ /pubmed/30533352 http://dx.doi.org/10.1016/j.eats.2018.07.003 Text en © 2018 by the Arthroscopy Association of North America. Published by Elsevier. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Technical Note
Hees, Tilman
Petersen, Wolf
Anterior Closing-Wedge Osteotomy for Posterior Slope Correction
title Anterior Closing-Wedge Osteotomy for Posterior Slope Correction
title_full Anterior Closing-Wedge Osteotomy for Posterior Slope Correction
title_fullStr Anterior Closing-Wedge Osteotomy for Posterior Slope Correction
title_full_unstemmed Anterior Closing-Wedge Osteotomy for Posterior Slope Correction
title_short Anterior Closing-Wedge Osteotomy for Posterior Slope Correction
title_sort anterior closing-wedge osteotomy for posterior slope correction
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261062/
https://www.ncbi.nlm.nih.gov/pubmed/30533352
http://dx.doi.org/10.1016/j.eats.2018.07.003
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