Artikel
The significance of the posterior tibial slope – a study of 811 patients with primary and revision ACL instability
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Veröffentlicht: | 25. Oktober 2022 |
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Gliederung
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Objectives: As the posterior tibial slope (PTS) is known to be a significant risk factor for primary and revision ACL reconstruction (ACLR) failure, little is known about the association between an elevated PTS and clinical or radiological parameters. The purpose of this study was to evaluate possible differences of patients with an elevated PTS (>12°) in comparison to patients with a PTS <12° in patients with primary and revision ACL reconstruction (ACLR).
Methods: Between 2017 and 2020, we conducted a retrospective study of 811 patients (307 women, 504 men; mean age 33.3 ± 12.4 years, range 18-63 years) undergoing primary (n=571) or revision (n=240) ACLR. Clinical and radiological data were collected and evaluated to determine possible differences between patients with a PTS >12° (n=218) in comparison to patients with a PTS <12° (n=593).
Results and conclusion: Patients with primary ACLR had a significant elevated PTS >12° in 23.3% of the cases (n=133), while patients with revision ACLR had an elevated PTS in 35.4% (n=85, p< 0.001).
Preoperative high-grade anterior knee instability (Lachman test grade 3) occurred significantly more often in patients with a PTS >12° (14.4% vs. 8.2%, p=0.007). Also, a preoperative high-grade rotational instability (pivot-shift grade 2/3) was seen more often in patients with a PTS >12° (20.3% vs. 13.3%, p=0.013). Osteoarthritis was detected more often in patients with an elevated PTS (19.3% vs. 13.6%, p=0.047). No differences were found between the two groups (PTS >12 vs. PTS < 12°) concerning medial meniscus lesions (39.3% vs. 36.7%, p=0.510), lateral meniscus lesions (22.5% vs. 22.1%, p=0.902), medial collateral ligament lesion (17.3% vs 18.5%, p= 0.704) and lateral collateral ligament lesion (13.1% vs. 13%, p=0.973).
An elevated PTS occurs in every fourth patient with primary and in every third patient with revision ACLR. A PTS>12° can be associated with high-grade anterior and rotational instability, revision ACLR and elevated risk of osteoarthritis.