➤ 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.

中文翻译：

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前十字韧带缺损情况下的斜坡截骨术。


➤ 胫骨后斜度 (PTS) ≥12° 是前交叉韧带 (ACL) 损伤和 ACL 重建失败的重要危险因素。➤ 根据所使用的成像方式和测量技术，PTS 测量可能存在显着差异。 PTS 应在严格的侧位 X 光片上测量，图像中推荐的胫骨近端长度为 15 厘米。 PTS 测量可以通过放置 2 个圆圈来定义近端胫骨轴，其中 1 个圆圈位于胫骨结节下方，另一个圆圈位于胫骨结节下方 10 厘米处。在磁共振成像和计算机断层扫描上进行时，PTS 测量值会被低估。➤ 可以使用 (1) 结节上法、(2) 结节反射经结节法或 (3) 结节下法进行坡度减小截骨术。修正目标仍然是一个争论的话题。尽管存在争议，但一些作者建议将胫骨倾斜度稍微过度矫正至 4° 至 6° 的范围。例如，如果初始坡度为 12°，则应进行 6° 至 8° 的校正，前提是目标胫骨坡度为 4° 至 6°。➤ 坡度减小截骨术后的临床结果良好。然而，潜在的并发症、关于减少坡度截骨术对骨关节炎影响的数据有限以及对髌股关节影响的不确定性都是值得注意的问题。➤ 复杂畸形的患者可能需要双平面截骨术来全面解决病情。