Does Posterior Tibial Slope Affect Graft Rupture Following Anterior Cruciate Ligament Reconstruction?

作者：Lee Chae Chil; Youm Yoon Seok; Cho Sung Do; Jung Seung Hyun; Bae Mun Hee; Park Seon Jae; Kim Han Wook

来源：Arthroscopy-The Journal of Arthroscopic and Related Surgery, 2018, 34(7): 2152-2155.

DOI：10.1016/j.arthro.2018.01.058

Purpose: The purpose of this study was to evaluate the association between posterior tibial slope (PTS) and anterior cruciate ligament (ACL) graft rupture in patients who have undergone ACL reconstruction by comparing results in patients who experienced graft rupture and a matched control group. Methods: The study included 64 knees of 64 patients (58 men and 6 women), of mean age 31 years (range, 18-60 years) who underwent revision ACL reconstruction for ACL graft rupture, as well as a control group without ACL graft rupture matched for age, sex, body mass index (BMI), and left or right side. The mean time to failure in study group was 48.5 months, and after revision surgeries, the mean follow-up period was 37.7 months. The graft used for the primary surgery was autograft in 3 patients (4.7%) and allograft in 49 patients (76.6%). The type of graft could not be confirmed in the remaining 12 patients (18.7%). PTS was measured on plain radiographs and compared in the 2 groups. Results: Mean PTS was significantly higher in patients with (13.2 degrees +/- 2.5 degrees; range, 8.5 degrees-18.2 degrees) than without (10.9 degrees +/- 3.1 degrees; range, 4.9 degrees-13.6 degrees) rerupture (P < .01). When mean PTS was compared in the 37 patients who underwent primary surgery by the same surgeon, it was significantly higher in patients with (13.5 degrees +/- 2.5 degrees; range, 8.5 degrees-18.2 degrees) than without (11.1 degrees +/- 2.9 degrees; range, 5.1 degrees-13.6 degrees) rerupture (P < .01). PTS in patients with rerupture was not significantly associated with age, gender, BMI, and right or left side. The odds ratio of ACL graft rupture in knees with PTS >= 12 degrees was 4.52 (P < .001). Conclusions: This study showed that mean PTS was significantly greater in patients with than without noncontact ACL graft rerupture (13.2 degrees vs 10.9 degrees, P < .01). The failure of ACL reconstruction appears to be associated with increased PTS, with PTS >= 12 degrees a risk factor for the failure of ACL reconstruction.

• 出版日期2018-7