The combination of a tibial slope correction osteotomy with ACL revision at a mean follow-up of 10 years provides good clinical results without revision surgery

OBJECTIVES: The objective is to discover the long-term outcome of ACL reconstruction associated with tibial slope correction osteotomy for a second ACL tear. This study is preceded by an initial publication with a 4-year follow-up. The hypothesis was stable functional scores and the absence of osteoarthritis progression. METHODS: The initial consecutive retrospective series included 9 patients who had a revision surgery for ACL reconstruction associated with single-stage OTDF. They were reviewed by an independent observer for a second follow-up with a minimum retrospect of 7 years. The analysis was based on IKDC-SKF and Lysholm scores, and radiographic analysis. RESULTS: Of the original 9 patients, 7 were seen again, 1 was only interviewed by telephone, and 1 was lost to follow-up. At the last follow-up of 9.9 ± 3.0 years, all 8 patients had stable or improved functional scores compared to the previous follow-up. The mean Lysholm score increased from 73.8 ± 5.8 (65-82) to 84.5 ± 11.9 (59-95) and the mean IKDC-SKF score increased from 71.6 ± 6.2 (62-79) to 82.9 ± 12.1 (61-98). Of the six patients who already had proof of osteoarthritis at the previous follow-up, the grade of osteoarthritis increased for two (with a history of meniscectomy, from grade 2 to grade 3 and from grade 1 to grade 3) but remained stable for three patients and could not be assessed for one. CONCLUSION: At 7-15 years (mean: 9.9 years), patients’ functional scores were stable or improving compared to the previous 2-8 year follow-up period, with no new tear or revision surgery. This validates tibial slope correction after recurrent ACL tears with an increase in the tibial slope