ArticleOrthopaedic surgery2025
Sagittal Inclination Angle of the Graft Affects Graft Maturity and Knee Stability After Anterior Cruciate Ligament Reconstruction.
Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- No Evidence of Superior Graft Remodeling and Maturation When Adding a Lateral Extra-articular Procedure to Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis of Comparative Studies.The American journal of sports medicine · 2026Pooled it
- Remnant Preservation in Anterior Cruciate Ligament Reconstruction Versus Non-Preservation Methods: A Systematic Review and Meta-Analysis.Orthopaedic surgery · 2025Pooled it
- Transtibial ACL reconstruction produces higher sagittal inclination angles than the native ACL: A systematic review and meta-analysis of MRI-based measurements in 2047 knees.Journal of experimental orthopaedics · 2026Article
- Graft orientation using the over-the-top technique in anterior cruciate ligament reconstruction: Magnetic resonance imaging-based study.Journal of experimental orthopaedics · 2026Article
- Effect of Hyperbaric Oxygen Therapy on Early MRI-Based Graft Healing Following ACL Reconstruction With Hamstring Autografts.Orthopaedic journal of sports medicine · 2026Article
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8 authors.
Funding
Abstract
objectiveThe influence of the graft sagittal inclination angle (SIA) on knee stability, biomechanics, and graft maturity has been elucidated. However, no study has comprehensively described the effects of SIA on the aforementioned postoperative prognostic indicators. So, we aimed to determine whether the sagittal inclination angle (SIA) of a graft is associated with postoperative graft maturity, joint stability, and joint function after anterior cruciate ligament (ACL) reconstruction.
methodsPatients who had undergone ACL reconstruction between April 2019 and February 2022 and those with intact ACL were eligible. Using magnetic resonance imaging, graft maturity was evaluated as the mean signal-to-noise quotient (SNQ) measured in three regions. Anterior tibial translation (ATT) was used to evaluate knee stability. Correlation analysis was conducted for the SIA, ATT, and clinical outcome scores. Multivariate stepwise regression analysis was used on the SIA and potential risk factors to determine their association with the graft SNQ. The SIA threshold of knee instability was calculated by receiver-operating characteristic curves.
resultsSixty-three postoperative patients were enrolled. The SIA was significantly negatively associated with graft SNQ value. A multivariate stepwise regression analysis showed that SIA and body mass index were significant influencing factors associated with the graft SNQ. Correlations between the SIA and medial and lateral ATT were statistically significant. A larger SIA resulted in a decreased probability of medial and lateral ATT ≥ 5 mm. The SIA threshold of an increased risk of lateral ATT ≥ 5 mm was < 44.4°. A positive correlation was observed between SIA and subjective symptom subscales in the KOOS.
conclusionsA low SIA is not conducive to graft maturation after ACL reconstruction. A larger graft SIA was correlated with better postoperative knee stability. However, the effect of the SIA on joint function was only significant in terms of symptoms. Therefore, these new findings provide new ideas for preoperative assessment and intraoperative determination of the ideal graft inclination.
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