
In ACL reconstruction (ACLR) patients with steep posterior tibial slope (≥15°) and anterior subluxation (≥6 mm), adding slope-reducing tibial osteotomy significantly reduced graft laxity (12% vs 35.4%) and anterior tibial subluxation. Benefits were most pronounced when preoperative slope was ≥16°. These findings support osteotomy as an adjunct to ACLR in this anatomical subgroup to improve graft outcomes and knee stability.
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