ArticleJournal of experimental orthopaedics2025
Steeper medial posterior tibial slope is associated with bilateral ACL injuries: A radiographic comparison with unilateral cases.
Article in Journal of experimental orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Posterior tibial slope is associated with ACL status rather than demographic factors: A cohort of 1406 patients.Journal of experimental orthopaedics · 2026Article
- Posterior tibial slope interpretation is method-dependent: No universal threshold for defining abnormality in primary and recurrent ACL rupture.Journal of experimental orthopaedics · 2026Article
- Intraoperative fluoroscopically assessment underestimates the posterior tibial slope in open-wedge high tibial osteotomy.Journal of experimental orthopaedics · 2026Article
- Steeper medial posterior tibial slope is associated with bilateral ACL injuries: A radiographic comparison with unilateral cases.Journal of experimental orthopaedics · 2025Article
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8 authors.
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Abstract
Purpose: The posterior tibial slope (PTS) plays a key role in knee biomechanics and may influence the risk of anterior cruciate ligament (ACL) rupture as well as the outcomes of its reconstruction. We hypothesised that a steeper medial posterior tibial slope (MPTS) would be associated with an increased risk of bilateral ACL reconstruction compared to unilateral reconstruction. This study aimed to test this hypothesis by comparing the MPTS between patients undergoing unilateral ACL reconstruction (uniACLR) and those requiring non-simultaneous bilateral ACL reconstruction (biACLR), using radiographic imaging. Methods: This single-centre retrospective study included 114 patients (57 uniACLR, 57 biACLR), matched by age, gender, body mass index (BMI), and presence of meniscal injury. The MPTS was measured on standardised lateral radiographs. Meniscal, cartilage, and ligamentous injuries were evaluated arthroscopically. Statistical analyses included univariate and multivariate models, with a significance threshold of Results: Patients in the biACLR group demonstrated a significantly higher MPTS compared to the uniACLR group (mean ± SD: 12.39° ± 2.74° vs. 8.16° ± 1.67°; mean difference 4.23°, 95% confidence interval: 3.35°-5.11°; Conclusion: A steeper MPTS is significantly associated with bilateral ACL reconstruction, suggesting it may represent an anatomical risk factor for repeated ACL injuries. Systematic assessment of MPTS may help identify patients at higher risk of contralateral ACL injury, aiding in surgical planning and postoperative monitoring. Level of Evidence: Level III, retrospective comparative cohort study.
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