Evidence map›Paper›PMID 41451713›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026

Infra-tubercle osteotomy preserves coronal alignment and reduces anterior laxity compared to retro-tubercle technique in revision anterior cruciate ligament reconstruction with slope correction.

Romir Patel, Ahmed Mabrouk, Souvik Paul, Christophe Jacquet, Matthieu Ollivier

Abstract readComparative Study
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Romir PatelDepartment of Orthopedic Surgery, APHM, CNRS, ISM, Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix Marseille University, Marseille, France.ORCID https://orcid.org/0000-0002-9813-4407
Ahmed MabroukDepartment of Orthopedic Surgery, APHM, CNRS, ISM, Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix Marseille University, Marseille, France.
Souvik PaulDepartment of Orthopedic Surgery, APHM, CNRS, ISM, Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix Marseille University, Marseille, France.
Christophe JacquetDepartment of Orthopedic Surgery, APHM, CNRS, ISM, Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix Marseille University, Marseille, France.ORCID https://orcid.org/0009-0006-4065-6049
Matthieu OllivierDepartment of Orthopedic Surgery, APHM, CNRS, ISM, Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix Marseille University, Marseille, France.ORCID https://orcid.org/0000-0002-6910-0873

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare infra-tubercle (IKO) versus retro-tubercle (RKO) slope-reducing osteotomy performed with revision anterior cruciate ligament reconstruction (ACLR) on survivorship, anterior laxity, alignment, union, complications and patient-reported outcome measures (PROMs).

methodsRetrospective comparative cohort at a tertiary centre including 107 consecutive revision ACLR + slope-reducing osteotomy cases (IKO n = 50; RKO n = 57). Primary outcomes were Kaplan-Meier survivorship for (1) revision-only and (2) global failure (earliest of revision or instrumented anterior laxity > 5 mm). Secondary outcomes included Rolimeter side-to-side laxity at 2 months/1 year/2 years, radiographic posterior tibial slope (ΔPTS) and hip-knee-ankle angle (ΔHKA), union time, complications/reoperations and knee injury and osteoarthritis outcome score (KOOS). Between-group comparisons used t-tests/χ²; survival was compared by the log-rank test. Significance p < 0.05.

resultsAt mean follow-up of 27.9 ± 4.4 months, crude revision rates were 5.26% (3/57; 95% confidence [CI]: 1.8%-14.4%) for IKO versus 20.0% (10/50; 95% CI: 11.2%-33.0%) for RKO (p = 0.048). Five-year Kaplan-Meier survivorship estimates showed no statistically significant differences at all endpoints. IKO demonstrated significantly lower instrumented laxity at all time points: 2.4 ± 2.1 versus 3.3 ± 2.0 mm at 2 months (p = 0.034), 3.5 ± 2.3 versus 4.8 ± 2.7 mm at 1 year (p = 0.010), and 4.0 ± 2.9 versus 5.8 ± 4.2 mm at 2 years (p = 0.013). Coronal alignment changes differed significantly between groups (ΔHKA + 0.45° ± 0.58° for IKO vs. -1.32° ± 1.20° for RKO, p < 0.001). PTS reduction was comparable between groups (ΔPTS -8.20° ± 1.61°, 95% CI: -8.6 to -7.8 vs. -7.90° ± 1.74°, 95% CI: -8.4 to -7.4, p = 0.35). Hardware removal was more frequent following IKO (38.8% vs. 17.2%, p = 0.016). Union was achieved universally in both groups, though healing time was longer after IKO (4.0 ± 0.9 vs. 3.2 ± 0.6 months, p < 0.0001).

conclusionIn revision ACLR for elevated PTS, IKO and RKO yield comparable survivorship and PROM gains. IKO demonstrated better preservation of coronal-plane alignment and lower residual anterior laxity, at the trade-off of more frequent elective hardware removal and slightly longer time to union. These data can inform technique selection and counselling. LEVEL OF EVIDENCE: Level III, retrospective comparative cohort.

Indexed as

Anterior Cruciate Ligament ReconstructionJoint InstabilityOsteotomyTibiaAdultAnterior Cruciate Ligament InjuriesFemaleHumansKnee JointMaleMiddle AgedPatient Reported Outcome MeasuresReoperationRetrospective StudiesYoung AdultACL revisioncoronal alignmenthigh tibial osteotomyposterior tibial slopesurvivorship

Identifiers

PMID41451713
PMCPMC12948336

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.