Infratuberosity Anterior Closing-Wedge High Tibial Osteotomy for Slope Correction in Anterior Cruciate Ligament–Deficient Knees

Graft failure after anterior cruciate ligament reconstruction is multifactorial, with increased tibia slope identified as one of the risk factors. Several slope-correcting osteotomies have been proposed to address this in revision surgery, with most of the procedures using a supratuberosity or transtuberosity approach. Although satisfactory results have been presented, severe complications involving the extensor mechanism can occur. In this Technical Note, an infratuberosity anterior closing-wedge high tibial osteotomy is demonstrated for slope correction in anterior cruciate ligament–deficient knees in the revision setting.