Table 1 Patient demographics

Age (years)

31

39

51

Sex

F

M

M

BMI

21.6

33.6

28.5

Smoking (PPD)

0.5

0

0

Comorbidities

Depression, Anxiety, Bipolar Disorder

None

None

Preoperative Exam

2B Lachman; + Pivot Shift

2B Lachman; + Pivot Shift

2B Lachman

Preoperative Tunnel Widening

19 mm

16 mm

N/A

Preoperative PTS

14^o

14^o

17^o

Preoperative Mechanical Alignment

3^o varus

–

3^o varus

Preoperative Medial Proximal Tibial Angle

87^o

–

88^o

Previous ACL graft(s)

1. BTB autograft

2. Hamstring allograft

1. BTB autograft

1. BTB autograft

2. Hamstring autograft

Stage 1 Procedure

1. Allograft bone dowel grafting of tibial & femoral tunnels

2. Anterior slope-correcting PTO

1. Arthroscopic debridement

2. Hardware removal

3. Bone dowel grafting of tibial tunnel

4. Anterior slope-correcting PTO

1. Anterior slope-correcting PTO with varus correction

2. Revision ACL-R (quadriceps tendon autograft)

Osteotomy Fixation

4-hole medial “X” plate; 2-hole lateral plate

Paired knotless anchors with high-strength tape-like suture on either side of the tibial tubercle

Paired knotless anchors with high-strength tape-like suture on either side of the tibial tubercle

Stage 2 Procedure

1. Corrective opening wedge HTO with iliac crest autograft

2. Hardware removal

3. Revision ACL-R (hamstring autograft)

1. Corrective opening wedge HTO with iliac crest autograft

2. Hardware removal

3. Revision ACL-R (quadriceps tendon autograft)

N/A