Sagittal Tibial Osteotomy

Volume 6 | Issue 2 | July-December 2021 | Page 39-45 | Anshu Shekhar, Puneeth K, Sachin Tapasvi


Author: Anshu Shekhar [1], Puneeth K [2], Sachin Tapasvi [2]

[1] Sushrut OrthoPlastic Clinic, Raipur, Chhattisgarh, India.
[2] The Orthopaedic Speciality Clinic, Pune, Maharashtra, India.

Address of Correspondence:

Dr. Anshu Shekhar,
Consultant, Sushrut OrthoPlastic Clinic, Raipur, Chhattisgarh, India.


The anatomy proximal tibia is such that the anterior part is higher than the posterior, both medially and laterally, which causes a natural posterior tibial slope (PTS). The ‘normal range’ of this slope is variable across geography, ethnicity and gender. The morphology of the slope has profound impact on knee biomechanics, especially with respect to the anterior and posterior cruciate ligaments. A high slope increases forces across the anterior cruciate ligament (ACL), while the posterior cruciate ligament (PCL) function is compromised when the slope is flat or reversed (sloping anteriorly). A flat or reversed slope also contributes to the ‘bony’ component of a genu recurvatum deformity, which can become symptomatic. A sagittal tibial osteotomy (STO) is one in which the PTS is altered without changing the coronal plane alignment. When the slope is reduced, it is known as an extension STO and when the slope is increased, it is known as a flexion STO. This review describes the biomechanics of the PTS; the planning, indications, technique and complications of a STO and discusses some case examples.

Keywords: Posterior tibial slope, Osteotomy, Sagittal plane deformity, Revision anterior cruciate ligament reconstruction, Genu recurvatum


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How to Cite this article: Shekhar A, Puneeth K, Tapasvi S | Sagittal tibial osteotomy | Asian Journal of Arthroscopy | July-December 2021; 6(2): 39-45.

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