Steeper posterior tibial slope correlates with greater tibial tunnel widening after anterior cruciate ligament reconstruction

Nagai, Kazuo; Tashiro, Yasutaka; Herbst, Elmar; Gale, Tom; Wang, Joon Ho; Irrgang, James J.; Anderst, William; Fu, Freddie H.

doi:10.1007/s00167-018-5004-5

Cited by 22 publications

(25 citation statements)

References 39 publications

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“…Some total knee arthroplasty (TKA) studies have indicated that an appropriate posterior slope component would improve the flexion angle (Arabori et al, ; Bellemans, Banks, Victor, Vandenneucker, & Moemans, ; Malviya, Lingard, Weir, & Deehan, ; Massin & Gournay, ). Thus, a better understanding of the factors relevant to the PTS would help to improve anterior cruciate ligament reconstruction, high tibial osteotomy, and TKA (Kuriyama et al, ; Nagai et al, ; Nha, Kim, Ahn, & Lee, ).…”

Section: Introductionmentioning

confidence: 99%

The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

Zhang

Wen

et al. 2020

Clinical Anatomy

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Background Whether the posterior tibial slope (PTS) is associated with the femoral condylar shape has remained unclear. Classical anatomical studies considered the sagittal profiles of femoral condyles to consist of two circles. Recently, an elliptical method was described to simplify the “two circles” model. Our purpose was to analyze the relationship between the PTS and the shape of the sagittal femoral condyle, that is, two circles and two ellipses, using magnetic resonance imaging (MRI) scans. Methods Eighty right knees of healthy subjects were scanned by MRI at full extension. The medial and lateral PTS were measured (mPTS and lPTS). On the distal‐most medial and lateral slices, the femoral condylar articular surfaces were best fitted by circles or ellipses, respectively. The radii of the medial and lateral posterior circles and inferior circles (rm and rl, Rm and Rl, respectively), the semi‐major axes and the semi‐minor axes of the medial and lateral ellipses (am and al, bm and bl, respectively), and the rm/Rm, bm/am, rl/Rl, bl/al ratios were measured and calculated. Results mPTS correlated significantly with the parameters of the medial condyle (all p < .05) and the ratios bm/am and rm/Rm (p = .017 and p = .027, respectively). However, the lPTS did not correlate with the parameters of the lateral condyle (all p > .05) or the ratios bl/al and rl/Rl (p = .461 and p = .241, respectively). Conclusion The mPTS is associated with the sagittal shape of the medial femoral condyle but the lPTS is not. Both two circles and two ellipses are feasible ways to represent the sagittal femoral condylar shape.

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Section: Introductionmentioning

confidence: 99%

The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

Zhang

Wen

et al. 2020

Clinical Anatomy

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“…26 In our study, we also noted an association between posterior tibial slope and tunnel size as has been demonstrated by prior authors. 27 Although the clinical relevance of the very small (1.7–1.8 degrees) difference in slope is not known, it is possible that increased slope leads to increased graft load and potentially increased graft motion and risk of tunnel widening.…”

Section: Discussionmentioning

confidence: 99%

Larger Prior Tibial Tunnel Size Is Associated with Increased Failure Risk following Revision Anterior Cruciate Ligament Reconstruction

et al. 2022

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We hypothesize that larger prior tunnel size is associated with an increased risk of failure of single-stage revision anterior cruciate ligament reconstruction (ACLR) as defined by the performance of a re-revision (third) ACLR on the index knee. Retrospective review identified 244 patients who underwent single-stage revision ACLR at a single center with available preoperative radiographs. Patient and surgical factors were extracted by chart review. The maximum diameter of the tibial tunnel was measured on lateral radiographs and the maximum diameter of the femoral tunnel was measured on anteroposterior radiographs. Record review and follow-up phone calls were used to identify failure of the revision surgery as defined by re-revision ACLR on the index knee. One hundred and seventy-one patients (70%) were reviewed with a mean of 3.9 years follow-up. Overall, 23 patients (13.4%) underwent re-revision surgery. Mean tibial tunnel size was 12.6 ± 2.8 mm (range: 5.7–26.9 mm) and mean femoral tunnel size was 11.7 ± 2.8 mm (range: 6.0–23.0 mm). Re-revision risk increased with tibial tunnel size. Tibial tunnels 11 mm and under had a re-revision risk of 4.2%, while tunnels > 11 mm had a risk of 17.1% (relative risk: 4.1, p = 0.025). No significant association between femoral tunnel size and re-revision risk was noted. Patients with prior tibial tunnels > 11mm in diameter at revision surgery had significantly increased risk of re-revision ACLR. Further studies are needed to explore the relationship between prior tunnel size and outcomes of revision ACLR.

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“…Several studies have found that increased lateral PTS results in greater TW after ACL reconstruction. 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

“… 7 , 11 , 12 , 13 Therefore, the correlation between femoral and tibial TW after anatomical ACL reconstruction using BTB grafts has not been fully understood. Even among the papers that studied the relationship between PTS and TW, most examined only the effects on the tibial side of TW, 7 , 8 , 9 and the effects on the femoral side of TW have rarely been investigated.…”

Section: Introductionmentioning

confidence: 99%

Lateral posterior tibial slope does not affect femoral but does affect tibial tunnel widening following anatomic anterior cruciate ligament reconstruction using a Bone–Patellar Tendon–Bone graft

Taketomi

Inui

Yamagami

et al. 2022

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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Steeper posterior tibial slope correlates with greater tibial tunnel widening after anterior cruciate ligament reconstruction

Abstract: III.

Cited by 22 publications

References 39 publications

The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

Larger Prior Tibial Tunnel Size Is Associated with Increased Failure Risk following Revision Anterior Cruciate Ligament Reconstruction

Lateral posterior tibial slope does not affect femoral but does affect tibial tunnel widening following anatomic anterior cruciate ligament reconstruction using a Bone–Patellar Tendon–Bone graft

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