{"id":"https://openalex.org/W7223650189","doi":"https://doi.org/10.1186/s12891-026-10665-8","title":"The role of slope-increasing tibial osteotomy in posterior cruciate Ligament Insufficiency and Reconstruction: A Scoping Review of techniques, biomechanics, and clinical outcomes","display_name":"The role of slope-increasing tibial osteotomy in posterior cruciate Ligament Insufficiency and Reconstruction: A Scoping Review of techniques, biomechanics, and clinical outcomes","publication_year":2026,"publication_date":"2026-10-26","ids":{"openalex":"https://openalex.org/W7223650189","doi":"https://doi.org/10.1186/s12891-026-10665-8"},"language":"en","primary_location":{"id":"doi:10.1186/s12891-026-10665-8","doi":"https://doi.org/10.1186/s12891-026-10665-8","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12891-026-10665-8","pdf_url":null,"source":{"id":"https://openalex.org/S35439863","display_name":"BMC Musculoskeletal Disorders","issn_l":"1471-2474","issn":["1471-2474"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Musculoskeletal Disorders","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12891-026-10665-8","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5015079805","display_name":"Prushoth Vivekanantha","orcid":"https://orcid.org/0000-0002-1298-5121","observed_orcids":["https://orcid.org/0000-0002-1298-5121"]},"institutions":[{"id":"https://openalex.org/I98251732","display_name":"McMaster University","ror":"https://ror.org/02fa3aq29","country_code":"CA","type":"education","lineage":["https://openalex.org/I98251732"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Prushoth Vivekanantha","raw_affiliation_strings":["Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada","institution_ids":["https://openalex.org/I98251732"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5117457365","display_name":"Marc Daniel Bouchard","orcid":"https://orcid.org/0009-0003-6883-9486","observed_orcids":["https://orcid.org/0009-0003-6883-9486"]},"institutions":[{"id":"https://openalex.org/I98251732","display_name":"McMaster University","ror":"https://ror.org/02fa3aq29","country_code":"CA","type":"education","lineage":["https://openalex.org/I98251732"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Marc Daniel Bouchard","raw_affiliation_strings":["Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada","institution_ids":["https://openalex.org/I98251732"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000775240","display_name":"Amit Meena","orcid":"https://orcid.org/0000-0002-0902-8873","observed_orcids":["https://orcid.org/0000-0002-0902-8873"]},"institutions":[{"id":"https://openalex.org/I2802577520","display_name":"Santokba Durlabhji Memorial hospital","ror":"https://ror.org/00jrxyr16","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I2802577520"]}],"countries":["IN"],"is_corresponding":false,"raw_author_name":"Amit Meena","raw_affiliation_strings":["Department of Orthopaedics, Santokba Durlabhji Memorial hospital, Jaipur, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopaedics, Santokba Durlabhji Memorial hospital, Jaipur, India","institution_ids":["https://openalex.org/I2802577520"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5093996671","display_name":"Prathik Hegde","orcid":"https://orcid.org/0009-0007-9497-5982","observed_orcids":["https://orcid.org/0009-0007-9497-5982"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Prathik Hegde","raw_affiliation_strings":["The Bangalore Hospital, Bengaluru, Karnataka, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Bangalore Hospital, Bengaluru, Karnataka, India","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101767643","display_name":"Neel Sharma","orcid":"https://orcid.org/0000-0002-3693-4185","observed_orcids":["https://orcid.org/0000-0002-3693-4185"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Neel Sharma","raw_affiliation_strings":["Department of Orthopedics, BDBA Municipal Hospital, Mumbai, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthopedics, BDBA Municipal Hospital, Mumbai, India","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102851712","display_name":"Apoorva Khajuria","orcid":"https://orcid.org/0000-0003-1679-1364","observed_orcids":["https://orcid.org/0000-0003-1679-1364"]},"institutions":[{"id":"https://openalex.org/I2800129641","display_name":"Great Ormond Street Hospital","ror":"https://ror.org/00zn2c847","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800129641","https://openalex.org/I2800349819"]},{"id":"https://openalex.org/I2800349819","display_name":"Great Ormond Street Hospital for Children NHS Foundation Trust","ror":"https://ror.org/03zydm450","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800349819"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Apoorva Khajuria","raw_affiliation_strings":["Great Ormond Street Hospital for Children NHS Foundation, London, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Great Ormond Street Hospital for Children NHS Foundation, London, UK","institution_ids":["https://openalex.org/I2800129641","https://openalex.org/I2800349819"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5005473325","display_name":"Darren L. de SA","orcid":"https://orcid.org/0000-0002-3997-4078","observed_orcids":["https://orcid.org/0000-0002-3997-4078"]},"institutions":[{"id":"https://openalex.org/I98251732","display_name":"McMaster University","ror":"https://ror.org/02fa3aq29","country_code":"CA","type":"education","lineage":["https://openalex.org/I98251732"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Darren de SA","raw_affiliation_strings":["Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada","institution_ids":["https://openalex.org/I98251732"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5043172416","display_name":"Sachin Ramchandra Tapasvi","orcid":"https://orcid.org/0000-0002-9778-3042","observed_orcids":["https://orcid.org/0000-0002-9778-3042"]},"institutions":[{"id":"https://openalex.org/I4210163767","display_name":"Sahyadri Hospital","ror":"https://ror.org/053kxry22","country_code":"IN","type":"healthcare","lineage":["https://openalex.org/I4210163767"]}],"countries":["IN"],"is_corresponding":true,"raw_author_name":"Sachin Tapasvi","raw_affiliation_strings":["Sahyadri Speciality Hospitals, Pune, India"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Sahyadri Speciality Hospitals, Pune, India","institution_ids":["https://openalex.org/I4210163767"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5043172416"],"corresponding_institution_ids":["https://openalex.org/I4210163767"],"apc_list":{"value":3090,"currency":"USD","value_usd":3090},"apc_paid":{"value":3090,"currency":"USD","value_usd":3090},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.8842286,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10442","display_name":"Knee injuries and reconstruction techniques","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10442","display_name":"Knee injuries and reconstruction techniques","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10562","display_name":"Total Knee Arthroplasty Outcomes","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11018","display_name":"Lower Extremity Biomechanics and Pathologies","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2204","display_name":"Biomedical Engineering"},"field":{"id":"https://openalex.org/fields/22","display_name":"Engineering"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/posterior-cruciate-ligament-reconstruction","display_name":"posterior cruciate ligament reconstruction","score":0.9819999933242798},{"id":"https://openalex.org/keywords/posterior-knee-instability","display_name":"posterior knee instability","score":0.9810000061988831},{"id":"https://openalex.org/keywords/posterior-tibial-slope","display_name":"posterior tibial slope","score":0.7950000166893005},{"id":"https://openalex.org/keywords/bone-grafting","display_name":"bone grafting","score":0.6470000147819519},{"id":"https://openalex.org/keywords/posterior-cruciate-ligament-deficiency","display_name":"posterior cruciate ligament deficiency","score":0.5379999876022339}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9390000104904175},{"id":"https://openalex.org/C2779866876","wikidata":"https://www.wikidata.org/wiki/Q18349435","display_name":"High tibial osteotomy","level":4,"score":0.8565000295639038},{"id":"https://openalex.org/C2776389721","wikidata":"https://www.wikidata.org/wiki/Q2167748","display_name":"Osteotomy","level":2,"score":0.671500027179718},{"id":"https://openalex.org/C2780345532","wikidata":"https://www.wikidata.org/wiki/Q735353","display_name":"Posterior cruciate ligament","level":3,"score":0.666700005531311},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.5564000010490417},{"id":"https://openalex.org/C175696284","wikidata":"https://www.wikidata.org/wiki/Q986524","display_name":"Cadaveric spasm","level":2,"score":0.5361999869346619},{"id":"https://openalex.org/C68312169","wikidata":"https://www.wikidata.org/wiki/Q216685","display_name":"Orthopedic surgery","level":2,"score":0.5248000025749207},{"id":"https://openalex.org/C43893838","wikidata":"https://www.wikidata.org/wiki/Q840545","display_name":"Sports medicine","level":2,"score":0.5199999809265137},{"id":"https://openalex.org/C146249460","wikidata":"https://www.wikidata.org/wiki/Q2914991","display_name":"Fixation (population genetics)","level":3,"score":0.43779999017715454},{"id":"https://openalex.org/C2777236700","wikidata":"https://www.wikidata.org/wiki/Q178366","display_name":"Tibia","level":2,"score":0.40540000796318054},{"id":"https://openalex.org/C2776337968","wikidata":"https://www.wikidata.org/wiki/Q3814234","display_name":"Bone grafting","level":2,"score":0.3919999897480011},{"id":"https://openalex.org/C2779753412","wikidata":"https://www.wikidata.org/wiki/Q39888","display_name":"Ligament","level":2,"score":0.35929998755455017},{"id":"https://openalex.org/C29694066","wikidata":"https://www.wikidata.org/wiki/Q118301","display_name":"Orthodontics","level":1,"score":0.3228999972343445},{"id":"https://openalex.org/C2778434673","wikidata":"https://www.wikidata.org/wiki/Q611127","display_name":"Anterior cruciate ligament","level":2,"score":0.30219998955726624},{"id":"https://openalex.org/C19648533","wikidata":"https://www.wikidata.org/wiki/Q691640","display_name":"Evidence-based medicine","level":3,"score":0.2912999987602234},{"id":"https://openalex.org/C2780887989","wikidata":"https://www.wikidata.org/wiki/Q4771338","display_name":"Anterior cruciate ligament reconstruction","level":3,"score":0.2906999886035919},{"id":"https://openalex.org/C2779699715","wikidata":"https://www.wikidata.org/wiki/Q3621623","display_name":"Cruciate ligament","level":3,"score":0.28760001063346863},{"id":"https://openalex.org/C170700871","wikidata":"https://www.wikidata.org/wiki/Q193378","display_name":"Biomechanics","level":2,"score":0.28679999709129333},{"id":"https://openalex.org/C2781017183","wikidata":"https://www.wikidata.org/wiki/Q7911553","display_name":"Valgus","level":2,"score":0.2806999981403351},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.27889999747276306},{"id":"https://openalex.org/C198451711","wikidata":"https://www.wikidata.org/wiki/Q327657","display_name":"Rheumatology","level":2,"score":0.2752000093460083},{"id":"https://openalex.org/C2778818304","wikidata":"https://www.wikidata.org/wiki/Q1819478","display_name":"Rehabilitation","level":2,"score":0.2741999924182892},{"id":"https://openalex.org/C2908736133","wikidata":"https://www.wikidata.org/wiki/Q37425","display_name":"Knee Joint","level":2,"score":0.2721000015735626},{"id":"https://openalex.org/C60465272","wikidata":"https://www.wikidata.org/wiki/Q494478","display_name":"Range of motion","level":2,"score":0.25920000672340393}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12891-026-10665-8","doi":"https://doi.org/10.1186/s12891-026-10665-8","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12891-026-10665-8","pdf_url":null,"source":{"id":"https://openalex.org/S35439863","display_name":"BMC Musculoskeletal Disorders","issn_l":"1471-2474","issn":["1471-2474"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Musculoskeletal Disorders","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12891-026-10665-8","doi":"https://doi.org/10.1186/s12891-026-10665-8","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12891-026-10665-8","pdf_url":null,"source":{"id":"https://openalex.org/S35439863","display_name":"BMC Musculoskeletal Disorders","issn_l":"1471-2474","issn":["1471-2474"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Musculoskeletal Disorders","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9391000270843506}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W1993854426","https://openalex.org/W7167457226","https://openalex.org/W4412717299","https://openalex.org/W7170090969","https://openalex.org/W3178056111","https://openalex.org/W4415435299","https://openalex.org/W2074686695","https://openalex.org/W2531772889","https://openalex.org/W4403718498","https://openalex.org/W2790129380"],"abstract_inverted_index":{"To":[0],"map":[1],"existing":[2],"evidence":[3,176],"on":[4,22,45],"slope-increasing":[5,58,95,238],"osteotomy":[6,98,110,239,246],"for":[7,49,203,247],"posterior":[8,13,166,272],"knee":[9],"instability":[10],"related":[11],"to":[12,36,179],"cruciate":[14],"ligament":[15,218],"(PCL)":[16],"insufficiency":[17,53],"or":[18,54,172,243],"PCL":[19,52,171,248,296],"reconstruction,":[20],"focusing":[21],"surgical":[23,68],"techniques,":[24],"biomechanical":[25,65,84,256],"effects,":[26],"and":[27,42,67,121,149,169,190,209,216,255,264,274,290,294],"clinical":[28,63,87,259],"outcomes.":[29],"A":[30,71],"scoping":[31],"review":[32],"was":[33,116,124,129,177],"conducted":[34],"according":[35],"PRISMA-ScR":[37],"guidelines,":[38],"with":[39,56,103,119,132,187,240,293],"PubMed,":[40],"MEDLINE,":[41],"EMBASE":[43],"searched":[44],"January":[46],"31":[47],"2026":[48],"studies":[50,61,75],"discussing":[51],"reconstruction":[55,219],"a":[57,94,106,137],"osteotomy.":[59],"Eligible":[60],"included":[62,145],"studies,":[64,85],"analyses,":[66],"technique":[69,81],"reports.":[70],"total":[72],"of":[73,140,229],"17":[74],"met":[76],"the":[77,160],"inclusion":[78],"criteria":[79],"(8":[80],"papers,":[82],"7":[83],"2":[86],"case":[88,181],"series).":[89],"Technique":[90],"reports":[91],"often":[92,117],"described":[93],"anterior":[96],"opening-wedge":[97],"(":[99,111,183],"n":[100,112,184],"=":[101,113,185],"5),":[102],"some":[104],"describing":[105],"biplanar":[107],"high":[108],"tibial":[109,161,167],"3).":[114],"Fixation":[115],"performed":[118],"plates":[120],"bone":[122],"grafting":[123],"universally":[125],"reported.":[126],"Target":[127],"correction":[128,288],"inconsistently":[130],"specified,":[131],"reported":[133,197,232],"goals":[134],"generally":[135],"targeting":[136],"final":[138],"slope":[139,286],"5\u201310":[141],"degrees.":[142],"Biomechanical":[143],"investigations":[144],"51":[146],"cadaveric":[147],"knees":[148],"15":[150],"computational":[151],"models.":[152],"Studies":[153],"consistently":[154],"demonstrated":[155],"that":[156,198],"increasing":[157],"PTS":[158],"shifted":[159],"resting":[162],"position":[163],"anteriorly,":[164],"reduced":[165],"sag,":[168],"decreased":[170],"graft":[173,276],"loading.":[174],"Clinical":[175],"limited":[178],"two":[180,210],"series":[182],"16),":[186],"heterogeneous":[188],"indications":[189],"techniques.":[191],"One":[192],"study":[193,228],"comprising":[194],"six":[195],"patients":[196,212,231],"one":[199],"patient":[200],"required":[201,213],"re-fixation":[202],"delayed":[204],"union":[205],"at":[206],"4":[207],"months":[208,222],"other":[211,227],"hardware":[214],"removal":[215],"subsequent":[217],"after":[220,237],"12":[221],"(reoperation":[223],"3/6;":[224],"50%).":[225],"The":[226],"10":[230],"improvement":[233],"in":[234,283],"functional":[235],"outcomes":[236,260],"no":[241],"complications":[242],"reoperations.":[244],"Slope-increasing":[245],"deficiency":[249],"is":[250],"supported":[251],"by":[252],"technical":[253],"descriptions":[254],"rationales,":[257],"yet":[258],"data":[261],"remain":[262],"sparse":[263],"require":[265],"further":[266],"investigation.":[267],"Slope":[268],"increases":[269],"can":[270],"reduce":[271],"sag":[273],"decrease":[275],"loads.":[277],"There":[278],"are":[279],"significant":[280],"knowledge":[281],"gaps":[282],"optimal":[284],"indications,":[285],"thresholds,":[287],"targets,":[289],"comparative":[291],"effectiveness":[292],"without":[295],"reconstruction.":[297]},"counts_by_year":[],"updated_date":"2026-10-29T09:56:32.521200","created_date":"2026-10-27T00:00:00"}
