scholarly journals The influence of tibial slope on anterior cruciate ligament graft failure risk is dependent on graft positioning

2019 ◽  
Vol 27 (1) ◽  
pp. 230949901983467
Author(s):  
Steffen Sauer ◽  
Robert English ◽  
Mark Clatworthy
Keyword(s):  
Anterior Cruciate Ligament ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Anterior Cruciate Ligament Graft ◽  
Failure Risk ◽  
Anterior Cruciate ◽  
Graft Positioning

scholarly journals The Ratio of Tibial Slope and Meniscal Bone Angle for the Prediction of ACL Reconstruction Failure Risk

2018 ◽  
Vol 04 (03) ◽  
pp. e152-e159 ◽  
Author(s):  
Steffen Sauer ◽  
Robert English ◽  
Mark Clatworthy
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Acl Graft ◽  
Failure Risk ◽  
Increased Risk ◽  
Acl Failure ◽  
Anterior Cruciate

Background A growing body of research is indicating that the tibial slope and the geometry of the tibiofemoral meniscal–cartilage interface may affect the risk of anterior cruciate ligament reconstruction (ACLR) failure. Increased lateral tibial posterior slope (LTPS) and reduced meniscal bone angle (MBA) are associated with increased risk of anterior cruciate ligament (ACL) injury. The significance of a LTPS–MBA ratio regarding the prediction of ACL failure risk remains unknown. As LTPS and MBA may eventually potentiate or neutralize each other, it is expected that a low LTPS–MBA ratio is associated with high chance of ACL graft survival while a high LTPS–MBA ratio is associated with high risk of ACL failure. Material and Methods Out of 1,487 consecutive patients who underwent hamstring ACLR between August 2000 and May 2013, 54 ACLR failures with intact lateral menisci were included in this study and matched one-to-one with 54 control participants by age, sex, graft, surgical technique, and graft fixation method. Control participants had undergone ACLR without signs of lateral meniscal injury, graft failure, or insufficiency. MBA and LTPS were assessed on magnetic resonance imaging. Logistic regression was used to identify LTPS/MBA key cut-off ratios. Results In this cohort, a LTPS–MBA ratio under 0.27 was associated with a 28% risk of ACLR failure (36% of patients), while a ratio exceeding 0.42 was associated with an 82% risk of ACLR failure (31% of patients). The odds of ACL failure increased by 22.3% per reduction of 1 degree in MBA (odds ratio [OR], 1.22; 95% limits, 1.1–1.34). No significant association was found between LTPS and the risk of ACL graft failure in transtibial ACLR, while the odds of ACL failure increased by 34.9% per degree of increasing LTPS in transportal ACLR (OR, 1.34; 95% limits, 1.01–1.79). No significant correlation was found between MBA and LTPS (p = 0.5). Conclusion Reduced MBA was associated with significantly increased risk of ACL graft failure. A ratio of LTPS and MBA was found to be useful for the prediction of ACLR failure risk and may preoperatively help to identify patients at high risk of ACLR failure. This may have implications for patient counseling and the indication of additional extra-articular stabilizing procedures.

Anterior Cruciate Ligament Graft Failure

2011 ◽  
Vol 39 (10) ◽  
pp. 2194-2198 ◽  
Author(s):  
Austin M. Barrett ◽  
Jason A. Craft ◽  
William H. Replogle ◽  
Josie M. Hydrick ◽  
Gene R. Barrett
Keyword(s):  
Anterior Cruciate Ligament ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Anterior Cruciate Ligament Graft ◽  
Anterior Cruciate

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.

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