A slope-correcting anterior closing wedge proximal tibial osteotomy is a powerful tool for correcting increased posterior tibial slope in the setting of a failed anterior cruciate ligament reconstruction. This case series documents three cases in which patients collapsed into varus following an anterior closing wedge proximal tibia osteotomy. Two patients had osteotomies fixated with a “suture-staple” construct, and all had medical comorbidities or reported noncompliance post-operatively. Therefore, meticulous care during the planning, execution, and rehabilitation phases is critical as multiple factors throughout the arc of care may contribute towards anterior closing wedge proximal tibial osteotomy varus collapse. Careful optimization of medical comorbidities and rigid fixation with either a plate and screws or compression staples should be used rather than a “suture-staple” to mitigate this risk. Level of evidence: IV.

中文翻译：

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前闭合楔形胫骨近端截骨术用于 ACL 翻修重建后内翻塌陷：病例系列

在前交叉韧带重建失败的情况下，斜度矫正前闭合楔形胫骨近端截骨术是一种强大的工具，用于矫正增加的胫骨后斜度。该病例系列记录了三个病例，其中患者在前闭合楔形近端胫骨截骨术后塌陷内翻。两名患者进行了用“缝合钉”结构固定的截骨术，并且所有患者都有医疗合并症或报告术后不顺从。因此，在计划、执行和康复阶段的细致护理至关重要，因为整个护理过程中的多种因素可能导致前闭合楔形胫骨近端截骨内翻塌陷。应使用钢板和螺钉或压缩钉而不是“缝合钉”来仔细优化医疗合并症和刚性固定来降低这种风险。证据等级：IV。