scholarly journals The Effect of Posterior Tibial Slope on the Risk of Revision Surgery After Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652110541
Author(s):  
Lene Dæhlin ◽  
Eivind Inderhaug ◽  
Torbjørn Strand ◽  
Anagha P. Parkar ◽  
Eirik Solheim
Keyword(s):  
Anterior Cruciate Ligament ◽  
Revision Surgery ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Graft Size ◽  
Posterior Tibial ◽  
Anterior Cruciate ◽  
Time From Injury

Background: A significant proportion of patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) later experience graft failure. Some studies suggest an association between a steep posterior tibial slope (PTS) and graft failure. Purpose: To examine the PTS in a large cohort of patients about to undergo ACLR and to determine whether a steep PTS is associated with later revision surgery. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective review of a cohort undergoing isolated ACLR between 2002 and 2012 (with 8-19 years of follow-up) was conducted. Preoperative sagittal radiographs of knees in full extension were used for measurements of the PTS. There were 2 independent examiners who performed repeated measurements to assess the reliability of the method. Statistical analyses were performed to compare the PTS in the groups with and without later revision surgery. Results: A total of 728 patients, with a mean age of 28 years at the time of surgery, were included. Overall, 10% (n = 76) underwent revision surgery during the observation period. The group of injured knees had a significantly steeper PTS compared with the group of uninjured knees (9.5° vs 8.7°, respectively; P < .05). The mean PTS in the no revision group was 9.5° compared with 9.3° in the revision group (not significant). Dichotomized testing of revision rates related to PTS cutoff values of ≥10°, ≥12°, ≥14°, ≥16°, and ≥18° showed no association of PTS steepness (not significant) to graft failure. Patients with revision were younger than the ones without (mean age, 24 ± 8 vs 29 ± 10 years, respectively) and had a shorter time from injury to ACLR (mean, 14 ± 27 vs 24 ± 44 months, respectively) as well as a smaller graft size (8.2 vs 8.4 mm, respectively; P = .040). Conclusion: The current study did not find any association between a steep PTS measured on lateral knee radiographs and revision ACL surgery. However, a steeper PTS was seen in the group of injured knees compared with the group of uninjured (contralateral) knees. Independent of the PTS, younger patients, those with a shorter time from injury to surgery, and those with a smaller graft size were found to undergo revision surgery more often.

Age-Related Changes of Posterior Tibial Slope and Its Roles in Anterior Cruciate Ligament Injury

2016 ◽  
Vol 101 (1-2) ◽  
pp. 70-77 ◽  
Author(s):  
Ying-hua Sun ◽  
Lian-xu Chen ◽  
Zhao-de Jiao ◽  
Li Wang ◽  
Rui-ming Zhang ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Curve Fitting ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Age Related ◽  
Anterior Cruciate ◽  
Age Related Changes

Nearly all previous studies in posterior tibial slope (PTS) and anterior cruciate ligament (ACL) injuries ignored age-related changes, and the published data are inconsistent. The objective of this study was to reveal age-related changes of PTS and its roles in ACL injury. Data for 2618 lower limbs were included initially based on the availability of lateral X-rays and a suitable femorotibial angle. The final 1431 subjects were analyzed according to age, sex, side, and injury status. Student t-tests, 1-way analysis of variance, and curve fitting were used to analyze data. The PTS in males was greater than that in females in the 0–9 and 30–39-year-old groups, but this pattern was reversed in the 40–49, 60–69, 70–79, and 80–89-year-old groups. The PTS was greater on the left side than on the right side in the 0–9, 10–19, 50–59, 60–69, and 80–89-year-old groups. The curve fitting for PTS demonstrated a trend of first decreasing and then increasing with aging. The PTS values differed significantly between knees with an ACL injury and those without in the 20–29, 30–39, and 40–49-year-old groups but not in the 50–59-year-old group. The PTS follows a trend of first decreasing and then increasing, and its role in ACL injury changes with advancing age. The higher PTS is only unrelated to the risk of ACL injury in age groups with a lower mean PTS value.

scholarly journals The relationship between posterior tibial slope and anterior cruciate ligament injury

2014 ◽  
Vol 67 (7-8) ◽  
pp. 216-221 ◽  
Author(s):  
Vladimir Ristic ◽  
Mirsad Maljanovic ◽  
Branislav Pericin ◽  
Vladimir Harhaji ◽  
Miroslav Milankov
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Anterior Cruciate Ligament Rupture ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Significant Difference ◽  
Anterior Cruciate

Introduction. The aim of this study was to identify an increased posterior tibial slope as a possible risk factor for anterior cruciate ligament injury. Material and Methods. Sixty patients were divided into two groups (with and without anterior cruciate ligament rupture). The posterior tibial slope on the lateral and medial condyles was measured by sagittal magnetic resonance imaging slices by means of computerized method using circles to determine tibial axis. Results. The patients with anterior cruciate ligament rupture had a statistically significantly (p=0.06) greater posterior tibial slope on the lateral tibial condyle than the control group (6.68?:5.64?), and a greater slope on the medial condyle (5.49?:4.67?) in comparison to the patients with the intact anterior cruciate ligament. No significant difference in the average values of angles was observed between males and females with anterior cruciate ligament rupture, the average value being 6.23? in men and 5.84? in women on the lateral condyle, and 4.53? in men and 4.53? in women on the medial condyle. Discussion and Conclusion. A statistically significant difference between the values of posterior tibial slope was observed between the groups with and without anterior cruciate ligament rupture, the sex having no affect on the value of the posterior tibial slope. The method of measuring angles should be unique.

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