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In cases of failed ACL reconstruction in the setting of high tibial slope, ACL revision plus a slope\u2010correcting tibial deflexion osteotomy is more effective than ACL revision plus a lateral extra\u2010articular procedure such as anterolateral ligament reconstruction or lateral extra\u2010articular tenodesis. Recent research has confirmed that slope\u2010reducing proximal tibial osteotomy improves outcomes in ACL reconstruction patients with elevated PTS, especially in ACL revision cases and in cases with PTS of 12\u00b0 or greater. Absent slope\u2010correcting osteotomy, patients with PTS of 12\u00b0 or greater have high rates of failure after hamstring ACL reconstruction and increased rates of failure after bone\u2013patellar tendon\u2013bone reconstruction. PTS reduction should be considered in patients having primary ACL reconstruction if PTS is greater than 12\u00b0 to 14\u00b0.<\/jats:p>","DOI":"10.1016\/j.arthro.2025.03.004","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T12:43:46Z","timestamp":1741697026000},"page":"3196-3199","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":14,"title":["<i>Editorial Commentary:<\/i>\n                    Posterior Tibial Slope\u2010Reducing Osteotomy Should Be Considered in Patients Having Primary Anterior Cruciate Ligament Reconstruction if Posterior Tibial Slope Is Greater Than 12\u00b0 to 14\u00b0"],"prefix":"10.1002","volume":"41","author":[{"given":"David H.","family":"Dejour","sequence":"first","affiliation":[{"name":"Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Dan","sequence":"additional","affiliation":[{"name":"University of New South 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