Purpose: The purpose of this study was to evaluate the outcomes of patients undergoing single-stage revision anterior cruciate ligament (ACL) reconstruction (ACLR) with bone-patellar tendon-bone (BPTB) autograft, anterior closing wedge proximal tibial osteotomy (ACWPTO) and lateral extra-articular tenodesis (LET). Methods: An institutional review board-approved retrospective study of all patients who underwent a revision ACLR using a BPTB autograft, ACWPTO and LET from a single centre from 2018 to 2023 was performed. Inclusion criteria were patients >18 years of age with a failed ACLR, posterior tibial slope (PTS) of >15°, previous ACL-tunnel diameters of <14 mm, and intact ipsilateral patellar tendon. PTS and anterior tibial translation (ATT) were measured using the mechanical axis on long weight-bearing lateral tibial radiographs. Conclusions: Single-stage revision ACLR using BPTB autograft, ACWPTO and LET in an ACL-deficient knee with high-grade pivot shift and increased PTS was safe and reliable, with significantly improved clinical and objective outcomes. Level of Evidence: Level IV, case series.
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Fritz et al. (2025) studied this question.
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