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This article presents a method of posteromedial opening-wedge osteotomy making use of a custom cutting help guide to correct increased tibial slope and metaphyseal varus deformity after recurrent graft failure. An autograft quadriceps tendon graft was chosen when it comes to revision anterior cruciate ligament graft. After exposure with an anteromedial incision a patient special cutting guide ended up being used to result in the high tibial osteotomy. The last fixation of this posteromedial open
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