ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Higher risk of contralateral anterior cruciate ligament (ACL) injury within 2 years after ACL reconstruction in under-18-year-old patients with steep tibial plateau slope.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Return to Sports: A Risky Business? A Systematic Review with Meta-Analysis of Risk Factors for Graft Rupture Following ACL Reconstruction.Sports medicine (Auckland, N.Z.) · 2023Pooled it
- Correlation Between Radiographic and MRI Posterior Tibial Slope Measurement on a Pediatric Population.Journal of clinical medicine · 2025Article
- High Long-term Survivorship From Revision After Physeal-Sparing "Over-the-Top" Anterior Cruciate Ligament Reconstruction and Lateral Tenodesis in Skeletally Immature Patients: 8- to 17-Year Follow-up.Orthopaedic journal of sports medicine · 2025Article
- Current concept on assessment and management of anterior cruciate ligament injury in skeletally immature athletes.Journal of experimental orthopaedics · 2025Review
- Posterior Tibial Slope Characteristics and Their Relationships With Thigh Muscle Morphology, Activation Patterns, and Dynamic Knee Valgus in Male and Female Soccer Players Before and After Fatigue: A Descriptive Laboratory Study.Orthopaedic journal of sports medicine · 2025Article
- Anterior Cruciate Ligament Reconstruction with Modified Transtibial Technique: Outcomes and Return to Sport in Athletes.Healthcare (Basel, Switzerland) · 2025Article
- Evaluation of the Stability, Revision Rate, and Complication Profile of Combined Anterior Cruciate Ligament Reconstruction with Lateral Extra-Articular Tenodesis and Hughston Procedure in Anterior Cruciate Ligament and Medial Collateral Ligament Injury: An 8-Year Cohort Study.Orthopaedic journal of sports medicine · 2025Article
- Article
- Does posterior tibial slope laterality exist? A matched cohort study between ACL-injured and non-injured knees.Journal of experimental orthopaedics · 2023Article
- Spontaneous healing of acute ACL ruptures: rate, prognostic factors and short-term outcome.Archives of orthopaedic and trauma surgery · 2023Article
- [Risk factors for contralateral anterior cruciate ligament injury after primary anterior cruciate ligament reconstruction].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2023Article
- The 25-year experience of over-the-top ACL reconstruction plus extra-articular lateral tenodesis with hamstring tendon grafts: the story so far.Journal of experimental orthopaedics · 2023Review
- Current trends in the anterior cruciate ligament part 1: biology and biomechanics.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Review
- Lateral posterior tibial slope and length of the tendon within the tibial tunnel are independent factors to predict tibial tunnel widening following anatomic anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Lateral tibiofemoral morphometry does not identify risk of re-ruptures after ACL reconstruction in children and adolescents.Journal of experimental orthopaedics · 2021Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the role of Tibial Plateau Slope (TPS) as risk factor for early Anterior Cruciate Ligament (ACL) reconstruction failure and contralateral ACL injury in a population of patients with less than 18 years of age and operated on with the same surgical technique.
methodsNinety-four consecutive patients (mean age 15.7 ± 1.5 years) with at least 2 years of follow-up, who underwent ACL reconstruction with a single-bundle plus lateral-plasty hamstring technique in the same centre were included. Subsequent ACL injuries (ipsilateral ACL revision or contralateral ACL reconstruction) were assessed within the first 2 years after surgery. Anterior, central, posterior TPS of medial compartment were measured on lateral radiographs and compared between patients with intact graft and those with a second injury. Cut-off values with sensitivity and specificity were calculated with receiver operating characteristic (ROC) analysis. Survival analysis for second ACL injuries and multivariate analysis were performed.
resultsEight patients (9%) had ipsilateral ACL Revision and eight patients (9%) had contralateral ACL reconstruction. Patients with contralateral injury had a higher Central TPS with respect to those without second injury (12.6° ± 2.8° vs 9.3° ± 3.7°, p = 0.042). No differences were present in patients with ipsilateral ACL revision. Sensitivity and specificity for central TPS slope ≥ 12° to detect a contralateral rupture were 63% and 75% (p = 0.0092), for Anterior TPS were 100% and 52% (p = 0.0009). Patients with TPS values exceeding these cut-offs had higher rate of contralateral ACL injuries (19%vs4%, p = 0.0420) and lower 2-year survival (p = 0.0049). Multivariate analysis identified pre-operative sport level and TPS (either anterior or central) as risk factors for contralateral injuries.
conclusionsSteep tibial plateau slope ≥ 12° is associated with a higher risk of contralateral ACL injury within 2 years after ACL reconstruction in patients less than 18 years of age. However, TPS has no role in early ipsilateral re-injury after combined ACL reconstruction and lateral plasty. The clinical relevance is that both the surgeon and the patient should be aware of this higher risk and consider it in the rehabilitation phase to reduce the incidence of such injuries. LEVEL OF EVIDENCE: III.
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