Concomitant Opening-Wedge Distal Femoral Osteotomy and Anterior Closing-Wedge Proximal Tibial Osteotomy With Tunnel Bone Grafting for the First Stage of a Revision Anterior Cruciate Ligament Reconstruction

Authors:

Luke V. Tollefson B.S., Evan P. Shoemaker B.A., Erik L. Slette M.D., Robert F. LaPrade M.D., Ph.D.

Abstract:

Multiple risk factors for anterior cruciate ligament (ACL) reconstruction graft failure have been reported, including improper tunnel placement, unrepaired meniscus or ligamentous injuries, and coronal/sagittal malalignment. Various biomechanical studies have reported on the increased forces experienced by the ACL graft when there is valgus malalignment or increased posterior tibial slope. This technique describes an opening-wedge distal femoral osteotomy to correct valgus alignment and a closing-wedge proximal tibial osteotomy to correct increased posterior tibial slope in the setting of an ACL reconstruction graft failure. This technique is the first stage of a 2-stage surgery in which the second stage is the revision ACL reconstruction. By performing both osteotomies first, the patient can begin weight bearing earlier after the revision ACL reconstruction.

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About the Author: Robert LaPrade, MD

Robert LaPrade, MD, PhD has specialized skills and expertise in diagnosing and treating complicated knee injuries. He has treated athletes at all levels, including Olympic, professional and intercollegiate athletes, and has returned numerous athletes back to full participation after surgeries. Recognized globally for his outstanding and efficient surgical skills and dedication to sports medicine, he has received many research awards, including the OREF Clinic Research Award considered by many a Nobel Prize in orthopedics. Dr. LaPrade is one of the most published investigators in his field, and many of the surgeries that he has developed are now performed worldwide and recognized as the “gold standard” for the treatment of complex knee injuries.

Robert LaPrade, MD PhD

Average rating:

26 reviews

Sue Stanek

Jan 2, 2020

by Sue Stanek on Robert LaPrade, MD PhD

So glad I waited for the best

I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. Previous attempts to make it better provided only temporary relief. (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. I am so glad I did! Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.
You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. Hey - if he is good enough for Olympic and professional athletes…..he's good enough for me! Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!
- From your 63 year old very appreciative patent ~

Nancy S Stevenson

Aug 14, 2019

by Nancy S Stevenson on Robert LaPrade, MD PhD

Right Knee Surgery After Auto Bicycle Accident

Dr. Robert F. LaPrade operated on my right knee in May of 2010. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. I can run, bike, & climb mountains. In fact 2 years ago I finished climbing the top 100 peaks in CO.

Jordan

Aug 2, 2019

by Jordan on Robert LaPrade, MD PhD

Very helpful

I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. This answers all my questions!

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