The Effect of Medial Tibial Slope on Anterior Tibial Translation and Short-Term ACL Reconstruction Outcome

Sauer, Steffen; Clatworthy, Mark

doi:10.1055/s-0038-1669929

Cited by 18 publications

(17 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When there is a loss of feedforward muscular activation control, for instance at foot positions that occur in a very short time span, an ACL (re)injury may occur in patients with a large PTPA because forces are not carried by the muscular components. This is in line with previous studies that showed that the PTPA correlates with an increased ATTp in ACL injured, ACL reconstructed and cadaveric knees [ 5 , 13 , 28 ]. We did find a significant CCA correlation between the LPTPA and muscle activation, which suggests that patients indeed amend their muscle activation to the anatomy of their knee, especially by reducing their medial hamstring activity when the LPTPA is larger.…”

Section: Discussionsupporting

confidence: 93%

Sagittal knee kinematics in relation with the posterior tibia slope during jump landing after an anterior cruciate ligament reconstruction

et al. 2020

View full text Add to dashboard Cite

Purpose An increased posterior tibia plateau angle is associated with increased risk for anterior cruciate ligament injury and re-rupture after reconstruction. The aims of this study were to determine whether the tibia plateau angle correlates with dynamic anterior tibia translation (ATT) after an anterior cruciate ligament reconstruction and whether the tibia plateau angle correlates with aspects of knee kinematics and kinetics during jump landing. Methods Thirty-seven patients after anterior cruciate ligament reconstruction with autograft hamstring tendon were included. Knee flexion angle and knee extension moment during single leg hops for distance were determined using a motion capture system and the dynamic ATT with its embedded method. The medial and lateral posterior tibia plateau angle were measured using MRI. Moreover, passive ATT was measured using the KT-1000 arthrometer. Results A weak negative correlation was found between the maximal dynamic ATT and the medial tibia plateau angle (p = 0.028, r = − 0.36) and between the maximal knee flexion angle and the lateral tibia plateau angle (p = 0.025, r = − 0.37) during landing. Patients with a smaller lateral tibia plateau angle show larger maximal knee flexion angle during landing than the patients with larger lateral tibia plateau angle. Also, the lateral tibia plateau angle is associated the amount of with muscle activity. Conclusion The posterior medical tibia plateau angle is associated with dynamic ATT. The maximal knee flexion angle and muscle activity are associated with the posterior lateral tibia plateau angle. Level of evidence III

show abstract

Section: Discussionsupporting

confidence: 93%

Sagittal knee kinematics in relation with the posterior tibia slope during jump landing after an anterior cruciate ligament reconstruction

et al. 2020

View full text Add to dashboard Cite

show abstract

“…21,24 Furthermore, the relationship between PTS and graft tear (as opposed to primary ACL injury) has been examined in fewer studies, with varying results. 4,15,17,21 Even fewer studies have examined the relationship between PTS and graft tear in the setting of revision ACL reconstruction. 12…”

Section: Discussionmentioning

confidence: 99%

“…14,21 Yet others have found significance for either the medial tibial slope alone or both the medial and the lateral tibial slopes being higher in patients with ACL injury. 3,7,12,15,17,22,26 Furthermore, the relationship between the PTS and graft or contralateral ACL injury in patients undergoing reconstruction specifically with patellar tendon autograft (PTG) has not been extensively reported.…”

mentioning

confidence: 99%

Posterior Tibial Slope in Patients Undergoing Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft: Analysis of Subsequent ACL Graft Tear or Contralateral ACL Tear

Shelbourne¹,

Benner²,

Jones³

et al. 2021

Am J Sports Med

View full text Add to dashboard Cite

Background: Reports on greater posterior tibial slope (PTS) and its relationship to subsequent anterior cruciate ligament (ACL) injury show conflicting results; it has not been studied much in patients after ACL reconstruction with patellar tendon autograft (PTG). Hypothesis: Patients who suffered a subsequent ACL injury would have a larger PTS than patients who did not suffer a subsequent injury after primary or revision ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Patients received primary (n = 2439) or revision (n = 324) ACL reconstruction with PTG and were followed prospectively to determine the rate of graft tear and contralateral ACL tear. The PTS was measured preoperatively on digital lateral view radiographs. Intersecting lines were drawn along the medial tibial plateau and posterior tibia; the value of the acute angle at the lines’ intersection was then subtracted from 90° to obtain the PTS. This procedure was completed by a clinical assistant with an intrarater reliability of 0.89. Chi-square analysis and t tests were used to determine the differences between rate of tears and measurements between groups. A threshold of PTS ≥10° was used for analysis. Results: The mean follow-up time was 11.6 ± 4.0 years. After primary surgery, the mean PTS in patients with graft tears was 5.4°± 3.1° versus 4.8°± 2.9° for patients without a tear ( P = .041). The mean PTS was 4.9°± 3.4° for patients with contralateral tears (not statistically significantly different than the no-tear group; P = .80). Furthermore, patients with primary reconstruction with PTS ≥10° had a statistically significantly higher rate of graft tear (9.7%) than patients with PTS ≤9° (4.8%) ( P = .003), but not a higher rate of contralateral tear. Among patients undergoing revision surgery, there were no statistically significant differences between the graft tear, contralateral tear, and no-tear groups with relation to PTS ≥10°. Conclusion: After primary ACL reconstruction, patients with PTS >10° had a higher rate of subsequent graft tear but not a higher rate of contralateral tear. With revision surgery, there was no significant association between PTS and the rate of subsequent tear. Therefore, caution should be exercised when considering more radical interventions, such as osteotomy, to prevent retear in patients with high PTS.

show abstract

“…Interestingly, further work has demonstrated that an increase in posterior slope is associated with greater anterior tibial translation in ACL-deficient knees. 8,41 These studies highlight the complex interplay between various bony and soft tissue structures within the knee and the influence that they have in determining knee kinematics and restraint to deformity.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of the Magnetic Resonance Imaging–Based Coronal Lateral Collateral Ligament Sign on Adolescent Anterior Cruciate Ligament Reconstruction Graft Failure

et al. 2021

View full text Add to dashboard Cite

Background: The coronal lateral collateral ligament (LCL) sign is the presence of the full length of the LCL visualized on a single coronal magnetic resonance imaging (MRI) slice at the posterolateral corner of the knee. The coronal LCL sign has been shown to be associated with elevated measures of anterior tibial translation and internal rotation in the setting of anterior cruciate ligament (ACL) tear. Hypothesis: The coronal LCL sign (with greater anterior translation, internal rotation, and posterior slope of the tibia) will indicate a greater risk for graft failure after ACL reconstructive surgery. Study Design: Cohort study; Level of evidence, 3. Methods: Retrospective review was performed of adolescent patients with ACL reconstruction: a cohort without graft failure and a cohort with graft failure. MRI was utilized to measure tibial translation and femorotibial rotation and to identify the coronal LCL sign. The posterior tibial slope was measured on lateral radiographs. Patient-reported outcomes were collected. Results: We identified 114 patients with no graft failure and 39 patients with graft failure who met all criteria, with a mean follow-up time of 3.5 years (range, 2-9.4 years). Anterior tibial translation was associated with anterolateral complex injury ( P < .001) but not graft failure ( P = .06). Internal tibial rotation was associated with anterolateral complex injury ( P < .001) and graft failure ( P = .042). Posterior tibial slope was associated with graft failure ( P = .044). The coronal LCL sign was associated with anterolateral complex injury ( P < .001) and graft failure ( P = .013), with an odds ratio of 4.3 for graft failure (95% CI, 1.6-11.6; P = .003). Subjective patient-reported outcomes and return to previous level of sport were not associated with failure. Comparison of MRI before and after ACL reconstruction in the graft failure cohort demonstrated a reduced value in internal rotation ( P = .003) but no change in coronal LCL sign ( P = .922). Conclusion: Our study demonstrates that tibial internal rotation and posterior slope are independent predictors of ACL graft failure in adolescents. Although the value of internal rotation could be improved with ACL reconstruction, the presence of the coronal LCL sign persisted over time and was predictive of graft rupture (without the need to make measurements or memorize values of significant risk). Together, these factors indicate that greater initial knee deformity after initial ACL tear predicts greater risk for future graft failure.

show abstract

The Effect of Medial Tibial Slope on Anterior Tibial Translation and Short-Term ACL Reconstruction Outcome

Cited by 18 publications

References 26 publications

Sagittal knee kinematics in relation with the posterior tibia slope during jump landing after an anterior cruciate ligament reconstruction

Sagittal knee kinematics in relation with the posterior tibia slope during jump landing after an anterior cruciate ligament reconstruction

Posterior Tibial Slope in Patients Undergoing Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft: Analysis of Subsequent ACL Graft Tear or Contralateral ACL Tear

Predictive Value of the Magnetic Resonance Imaging–Based Coronal Lateral Collateral Ligament Sign on Adolescent Anterior Cruciate Ligament Reconstruction Graft Failure

Contact Info

Product

Resources

About