Osteotomy for Malalignment Following Failed ACL Reconstruction

  • Davide Edoardo Bonasia
  • Massimiliano Dragoni
  • Annunziato Amendola


Failed anterior cruciate ligament reconstruction represents a challenge in orthopedics and surgeons are often compelled to face many different complicated clinical situations. No decision-making algorithms are available regarding tibial osteotomy and ACL revision and every case must be carefully studied and planned. Even though little evidence is available regarding high tibial osteotomy (HTO) and ACL revision, the importance of limb alignment is widely accepted, and even though HTO is almost never indicated in malaligned knees with acute ACL tear, malalignment is a widely recognized cause of ACL failure.

The aim of this chapter is to describe the indications for osteotomies in ACL revision surgery, the patient’s history and examination, the preoperative planning, and the surgical techniques in order to allow surgeons to better understand the goals that should be achieved in ACL revision surgery.


Anterior Cruciate Ligament Reconstruction Femoral Tunnel Medial Collateral Ligament High Tibial Osteotomy Tibial Tunnel 
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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Davide Edoardo Bonasia
    • 1
  • Massimiliano Dragoni
    • 2
  • Annunziato Amendola
    • 3
  1. 1.Orthopaedics and TraumatologyCTO HospitalTurinItaly
  2. 2.Orthopaedics and TraumatologyPoliclinico Tor Vergata, University of Rome Tor VergataRomeItaly
  3. 3.Department of Orthopaedics and RehabilitationUniversity of Iowa Hospital and ClinicsIowa CityUSA

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