Table 2.

Advantages and Disadvantages of a Concomitant Opening-Wedge Distal Femoral Osteotomy and Anterior Closing-Wedge Proximal Tibial Osteotomy

Advantages	Disadvantages
Allows for correction of increased posterior slope and valgus coronal malalignment simultaneously	Potential increase in hyperextension
Anterior approach allows optimal access to ACL tibial tunnel for bone grafting in staging process	Requires extended 8-week period of non–weight bearing after the procedure
Not limited by bone healing in second stage of surgery for revision ACLR.	Potential for damage to popliteal and other posterior neurovascular structures with anteroposterior drilling
Bone from closing wedge can be used for ACL tunnel and distal femoral osteotomy bone grafting	More difficult to properly correct valgus angle when performing concomitant closing-wedge proximal tibial osteotomy.
Weight-bearing and extension work during postoperative rehabilitation for the revision ACLR can begin sooner.

ACL, anterior cruciate ligament; ACLR, anterior cruciate ligament rehabilitation.