CASE: Fourteen-year-old boy, history of autism presented with bilateral knee instability. Imaging revealed bilateral anterior cruciate ligament (ACL) insufficiency, 20掳 of posterior tibial slope (PTS) on the right and 18掳 on the left. A guided growth technique using anterior placed tension band plates was used to correct the PTS. At 22 months, the PTS corrected to 5.5掳 on the right and 6掳 on the left. The patient's knee stability improved, and he resumed activities at 30 months. CONCLUSION: Pediatric ACL insufficiency in the setting of elevated PTS can be successfully corrected with a guided growth technique.
