Assessment and surgical correction of posterior tibial slope in revision anterior cruciate ligament surgery: An international expert Delphi consensus statement.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The following authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Alan Getgood: Aesculap/B.Braun: Research support. American Journal of Sports Medicine: Editorial or governing board. Graymont Inc: IP royalties. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. LinkX Robotics: Stock or stock Options. Ossur: Research support. Ostesys Robotics: Stock or stock Options. Precision OS: Stock or stock Options. Smart HTO: Stock or stock Options. Smith & Nephew: Paid consultant; Paid presenter or speaker; Research support. Spring Loaded Technologies Inc: Stock or stock Options. Surgical Health Innovations Corp: Stock or stock Options. Volker Musahl: ACL Study Group: Board or committee member. American Orthopaedic Society for Sports Medicine: Board or committee member. Arthrex, Inc: Other financial or material support. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. JISAKOS: Board or committee member. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Newclip: Paid consultant. Ostesys: Stock or stock Options. Smith & Nephew: Other financial or material support; Paid consultant. Springer: Publishing royalties, financial or material support Sachin Tapasvi: Asia Pacific Orthopaedic Assocation: Board or committee member. Indo-European Arthroscopy Arthroplasty Foundation: Board or committee member. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. Jaypee Publishers: Publishing royalties, financial or material support. journal of ISAKOS: Editorial or governing board. Newclip Technic: Paid presenter or speaker. Smith & Nephew: Paid consultant; Paid presenter or speaker. Michael J Alaia: AAOS: Board or committee member. Arthrex, Inc: Paid consultant. Arthroscopy: Editorial or governing board. Arthroscopy Association of North America: Board or committee member. BodyCad: Paid consultant. Globus Medical: Paid consultant. Journal of Cartilage and Joint Preservation: Editorial or governing board. Mitek: Paid consultant. Orcosa, Inc: Research support. Overture: Stock or stock Options. Springer: Publishing royalties, financial or material support Annunziato Amendola: Am J Sports Med: Editorial or governing board. Arthrex, Inc: IP royalties. Bone Solutions Inc: Stock or stock Options. Journal of Isakos: Editorial or governing board. Miach Orthopedics Inc: Stock or stock Options. Springer: Publishing royalties, financial or material support. Stryker: Research support. Wolters Kluwer Health - Lippincott Williams & Wilkins: Publishing royalties, financial or material support Roland Becker: Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Mathys Ltd: Paid presenter or speaker. Charles H Brown Jr: Smith & Nephew: Paid consultant; Paid presenter or speaker. Jorge Chahla: American Orthopaedic Society for Sports Medicine: Board or committee member. Arthrex, Inc: Paid consultant. Arthroscopy Association of North America: Board or committee member. CONMED Linvatec: Paid consultant. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. Ossur: Paid consultant. RTI Surgical Inc.: Paid consultant. Smith & Nephew: Paid consultant; Paid presenter or speaker. Vericel Corporation: Paid consultant. Mark Clatworthy: Arthrex, Inc: IP royalties; Other financial or material support. DePuy, A Johnson & Johnson Company: Other financial or material support; Paid consultant; Paid presenter or speaker. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. David Dejour: Arthrex, Inc: IP royalties. Corin U.S.A.: IP royalties. European Society Sport & Knee Arthroscopy (ESSKA): Board or committee member. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. SBM: IP royalties. Smith & Nephew: Paid consultant. Zimmer: Paid consultant. Karl-Heinz Frosch: Arthrex, Inc: IP royalties; Paid presenter or speaker; Research support Pablo E Gelber: CONMED Linvatec: IP royalties; Paid consultant; Paid presenter or speaker. NewClip: Paid consultant; Paid presenter or speaker. Daniel Guenther: AGA-Society for Arthroscopy and Joint-Surgery (Research Comittee): Board or committee member. Anika: Paid presenter or speaker. Arthrex, Inc: Paid consultant; Paid presenter or speaker; Research support. BMC Musculoskeletal Disorders: Editorial or governing board. DIZG: Paid presenter or speaker. European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA): Board or committee member. Geistlich: Paid presenter or speaker. German Association for Traumatology (DGU): Board or committee member. German Knee Society (DKG): Board or committee member. International Journal of Orthopaedics: Editorial or governing board. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Medi: Paid presenter or speaker. Medical Magnesium: Paid consultant; Paid presenter or speaker. Rimasys: Paid consultant; Paid presenter or speaker. Smith & Nephew: Paid consultant. Storz: Paid consultant; Paid presenter or speaker. Stryker: Paid consultant; Paid presenter or speaker. S Mark Heard: Smith and Nephew: Type: IP Royalties. Ronald van Heerwaarden: Newclip Technics: Paid consultant. Michael T Hirschmann: AGA: Board or committee member. BMC Sports Medicine, Arthroscopy, Rehabilitation, Therapy&Technology: Editorial or governing board. DePuy, A Johnson & Johnson Company: Paid consultant; Paid presenter or speaker. ESSKA: Board or committee member. European Knee Associates (EKA): Board or committee member. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Lima: Paid consultant; Paid presenter or speaker. Muscle Ligament Tendon Journal (MLT): Editorial or governing board. Smith & Nephew: Paid consultant; Paid presenter or speaker. Symbios: Paid consultant; Paid presenter or speaker. Florian B Imhoff: Arthrex, Inc: Paid presenter or speaker. Kristian Kley: Newclip: IP royalties; Unpaid consultant. Robert F LaPrade: Type: Other Intellectual Property. Smith and Nephew: Type: Other Professional Activities. ISAKOS-Deputy Chair, traveling fellowship committee ISAKOS-Scientific Committee: Type: Board of Directors or committee member Self. AJSM, KSSTA, JEO, JISPT, OTSM, JKS: Type: Editorial or governing board Self. Bruce A Levy: Arthrex, Inc: IP royalties; Paid consultant. COVR Medical LLC: Stock or stock Options. Journal of Knee Surgery: Editorial or governing board. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Orthopedics Today: Editorial or governing board Walter R Lowe: Arthrex, Inc: IP royalties; Paid consultant; Paid presenter or speaker. Herodicus Society/Secretary Treasurer/President 2026: Board or committee member. Sébastien Lustig: Stryker Corporation: Type: Other Professional Activities. European Knee Society, ISAKOS: Type: Board of Directors or committee member Self. JBJS Am: Type: Editorial or governing board Self. Rodrigo Maestu: Arthroscopy Argentine Association: Board or committee member. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. Latin American Arthroscopy, Knee and Sports Society: Board or committee member. Permedica: Paid consultant. Smith & Nephew: Paid consultant. Jacques Menetrey: DePuy, A Johnson & Johnson Company: Paid consultant. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Springer: Publishing royalties, financial or material support Philippe Neyret: Elsevier: Publishing royalties, financial or material support. latilini: Paid presenter or speaker. medacta: Paid presenter or speaker. Medacta international: Paid consultant. orthopaedic studio: Paid presenter or speaker. Smith & Nephew: Paid consultant; Paid presenter or speaker. Springer: Publishing royalties, financial or material support. Studio santé: Paid consultant. United Europe: Paid consultant. United OC: Paid presenter or speaker. Matthieu Ollivier: Arthrex, Inc: Paid consultant. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. newclip: Paid consultant. Stryker: IP royalties; Paid consultant. David A Parker: ACL Study Group: Board or committee member. AJSM: Editorial or governing board. Asia Pacific Knee Arthroscopy and Sports Medicine Society: Board or committee member. Asia Pacific Knee Society: Board or committee member. Ganymed Robotics: Stock or stock Options; Unpaid consultant. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. OJSM, JISAKOS: Editorial or governing board. Personalised Surgery: Stock or stock Options. SMARTT Journal: Editorial or governing board. Smith & Nephew: Paid consultant; Paid presenter or speaker. Zimmer: Research support Wolf Petersen: Arthrex, Inc: Paid presenter or speaker. Deutsche Kniegesellschaft, GOTS: Board or committee member. Geistlich: Paid presenter or speaker. Karl Storz: IP royalties. Kniejournal: Editorial or governing board. OPED, Valley, Germany: Paid consultant. Anil S Ranawat: AAOS: Board or committee member. American Journal of Sports Medicine: Editorial or governing board. American Orthopaedic Society for Sports Medicine: Board or committee member. Anika: Paid consultant. Bodycad: Paid consultant. Cervos: Paid consultant. CONMED Linvatec: Paid consultant. Current Trends in Musculoskeletal Medicine: Editorial or governing board. Depuy Mitek-Synthes: Research support. DePuy, A Johnson & Johnson Company: IP royalties. Enhatch: Stock or stock Options. EOA: Board or committee member. Journal of Arthroplasty: Editorial or governing board. Moximed: Paid consultant. NewClip: Paid consultant. Overture: Stock or stock Options. Ranfac: Paid consultant. Saunders/Mosby-Elsevier: Editorial or governing board. Smith & Nephew: Paid consultant. Springer: Editorial or governing board Romain Seil: Arthrex, Inc: Paid presenter or speaker. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Smith & Nephew: Paid presenter or speaker. Seth L Sherman: ACL Study Group: Board or committee member. Aesculap Biologics LLC: Research support. American Orthopaedic Society for Sports Medicine: Board or committee member. AO: Paid consultant. Arcuro: Paid consultant. Arthrex, Inc: Paid consultant. Arthroscopy Association of North America: Board or committee member. Biologics Alliance: Board or committee member. CONMED Linvatec: IP royalties; Paid consultant. Current Reviews in Musculoskeletal Medicine: Editorial or governing board. DJO: IP royalties; Paid consultant. Icarus Bracing: Paid consultant; Stock or stock Options. International Cartilage Regeneration & Joint Preservation Society: Board or committee member. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. International Sports Medicine Fellows Conference: Board or committee member. JRF: Research support. Kinamed: Paid consultant. Lifenet: Paid consultant. LinkX: Paid consultant; Stock or stock Options. Miach Orthopaedics Inc.: Research support. Moximed Inc.: Paid consultant; Stock or stock Options. Organogenesis Inc.: Research support. Ossio: Research support. Ostesys: Paid consultant; Stock or stock Options. Reparel: Paid consultant; Stock or stock Options. Sarcio: Paid consultant; Stock or stock Options. Smith & Nephew: Research support. Sparta Biomedical: Paid consultant. University of Pittsburgh: Research support. Vericel: Paid consultant. Video Journal of Sports Medicine: Editorial or governing board. Vivorte: Paid consultant; Stock or stock Options. Konrad Słynarski: Anika: Paid presenter or speaker. Askel Healthcare: Paid consultant. Bertrand Sonnery-Cottet: AREAS: Stock or stock Options. Arthrex, Inc: IP royalties; Paid consultant. Tim Spalding: CONMED Linvatec: IP royalties; Paid presenter or speaker. Episurf: Paid consultant; Paid presenter or speaker. ICRS Cartilage Foundation: Board or committee member. Joint Operations UK: Paid presenter or speaker. Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Orthonika: Paid consultant; Stock or stock Options. Smith & Nephew: Paid presenter or speaker. René Verdonk: Knee Surgery, Sports Traumatology, Arthroscopy: Editorial or governing board. Orteq: Paid consultant; Paid presenter or speaker. Armando F Vidal: AAOS: Board or committee member. American Orthopaedic Society for Sports Medicine: Board or committee member. Arthrex, Inc: Research support. Stryker: IP royalties; Paid consultant. Brian R Waterman: AAOS: Board or committee member. American Orthopaedic Society for Sports Medicine: Board or committee member. American Shoulder and Elbow Surgeons: Board or committee member. Arthrex, Inc: Other financial or material support; Paid consultant; Paid presenter or speaker. Arthroscopy: Editorial or governing board. Arthroscopy Association of North America: Board or committee member. Kaliber AI: Stock or stock Options; Unpaid consultant. Smith & Nephew: Other financial or material support. Sparta: Paid presenter or speaker; Stock or stock Options; Unpaid consultant. Vericel: Paid presenter or speaker. Video Journal of Sports Medicine: Editorial or governing board. Vivorte: Stock or stock Options. Andreas Weiler: DJ Orthopaedics: Paid presenter or speaker. Linvatec: IP royalties. Medacta: Paid consultant. Storz: IP royalties; Paid consultant. Andy Williams: Doc Coms: Stock or stock Options. Innovate Orthopaedics: Unpaid consultant. Innovate Orthopaedics and Fortius Clinic: Stock or stock Options. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: Board or committee member. Smith & Nephew: Paid presenter or speaker; Research support Adrian Wilson: Arthrex, Inc: IP royalties; Paid consultant; Paid presenter or speaker; Research support. Newclip: IP royalties; Paid consultant; Paid presenter or speaker. The remaining authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 8. AJR Am J Roentgenol. 2022 Apr;218(4):701-712. doi: 10.2214/AJR.21.26659. Epub 2021 Nov 24. High Tibial Osteotomy: An Update for Radiologists. Li OL(1), Pritchett S(1), Giffin JR(2), Spouge ARI(1). Author information: (1)Department of Medical Imaging, Musculoskeletal Division, Schulich School of Medicine of Western University, University Hospital, London Health Sciences Centre, 339 Windermere Rd, London, ON N6A 5A5, Canada. (2)Fowler Kennedy Sport Medicine Clinic and Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Comment in AJR Am J Roentgenol. 2022 Apr;218(4):713. doi: 10.2214/AJR.21.27143. High tibial osteotomy (HTO) is a surgical procedure to treat symptomatic unicompartmental osteoarthritis (OA) associated with knee malalignment. There has been a recent resurgence of interest in HTO in patients who prefer joint-preserving surgery because HTO shifts the knee's mechanical axis from the arthritic compartment to a neutral position, thereby reducing knee pain, slowing progression of OA, and delaying the need for a total knee arthroplasty. The ideal candidates for HTO are patients who are young, active, and nonobese who have isolated varus deformity of the knee resulting from medial compartment OA. Radiography is critical in the preoperative evaluation for HTO and can help expand surgical indications to include a wider variety of patients. Radiography is also routinely obtained in postoperative assessment and is typically the first test to indicate complications. This review describes the radiologic aspects of HTO, including preoperative imaging assessment and normal and abnormal postoperative imaging appearances. Surgical techniques and osteotomy fixation devices are described, with a focus on the medial opening wedge approach. Given the growing interest in HTO, radiologists should become familiar with the basics of the procedure and the role of imaging in preoperative and postoperative evaluation. DOI: 10.2214/AJR.21.26659