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Increased Posterior Tibial Slope is Associated with ACL Graft and Contralateral ACL Injury after ACL Reconstruction


Justin Webb, MBBS, FRACS
AUSTRALIA

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Increased Posterior Tibial Slope is Associated with ACL Graft and Contralateral ACL Injury after ACL Reconstruction

Justin Webb, MBBS, FRACS, AUSTRALIA Etienne Leclerc, MD, AUSTRALIA Lucy J. Salmon, PhD, AUSTRALIA Leo A. Pinczewski, MBBS, FRACS, FAOA, AUSTRALIA Justin P. Roe, FRACS, A/Prof., AUSTRALIA

North Sydney Orthopaedic & Sports Medicine Centre, Sydney, NSW, AUSTRALIA

2013 Congress   Paper Abstract   2013 Congress   Not yet rated

 

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Instability

Sports Medicine

Preventative Sports Medicine Outcome Studies

Treatment / Technique

Autograft

Ligaments

ACL

Summary: An increased PTS is associated with an increased incidence of long term further ACL injury after ACL reconstruction to both the reconstructed and the contralateral knee.

Introduction

ACL injury is multifactorial, but previous studies have shown that an increased PTS can be a risk factor for primary ACL injury. The purpose of this study is to determine if an increased PTS also predisposes to a second injury after ACL reconstruction, either an ACL graft rupture or a contralateral ACL rupture.

Methods

Two hundred consecutive subjects with isolated ACL rupture who underwent primary ACL reconstruction with hamstring tendon autograft between October 1993 and March 1996 were enrolled in the study. Both the 15 year outcome was known and radiographic PTS was measureable in 181 subjects. This included 131 intact graft/contralateral ACL, 31 ACL graft ruptures, 15 contralateral ACL ruptures and 4 who sustained both ACL graft and contralateral ACL injury. The PTS was measured on a digitized lateral radiograph of the knee using the Proximal Anatomical Axis (PAA).

Results

An increased incidence of further ACL injury was found in subjects with a PTS greater than 12° when compared to subjects with a PTS less than 12° (56% vs 25%; p=0.007). The average PTS was 9.2°. The average PTS for any re-injury was 9.7° compared to 8.8° for no further injury. The average PTS for both ACL graft and contralateral ACL rupture was 12.6°.

Conclusion

An increased PTS is associated with an increased incidence of long term further ACL injury after ACL reconstruction to both the reconstructed and the contralateral knee. PTS should be considered when counselling patients returning to sports after ACL reconstruction.