ArticleOrthopaedic journal of sports medicine2025
Association Between Secondary ACL Injury and Tibial Spine Height After Primary ACL Reconstruction: A Case-Control Study.
Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: The anterior cruciate ligament (ACL) is essential for knee stability, and reconstruction aims to restore functionality. High secondary ACL injury rates after primary ACL reconstruction (ACLR) pose significant clinical, public health, and economic challenges. Although tibial spine height (TSH) has been identified as a risk factor for primary ACL injuries, its role in secondary ACL injury after primary ACLR remains poorly understood. Purpose: To investigate whether the increase in TSH between pre- and postoperative MRI measurements is associated with secondary ACL injury after primary ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: A case-control study was conducted at a single institution, including 32 patients who underwent revision surgery after noncontact secondary ACL injury and 107 patients who maintained intact ACL grafts without revision after primary ACLR during a minimum 2-year follow-up period. The primary outcome was the increase in TSH between pre- and postoperative MRI scans. Logistic regression was used to examine the association between the increase in TSH and secondary ACL injury, and the area under the receiver operating characteristic (ROC) curve (AUC) was calculated to assess the model's discriminative ability. Other imaging characteristics and anteroposterior instability using KT-2000 were analyzed. Results: Each 1-mm increase in postoperative medial TSH (MTSH) was associated with secondary ACL injury (adjusted odds ratio, 7.62; 95% CI, 3.80-18.55; Conclusion: This study demonstrates a significant association between increased MTSH and secondary ACL injury after primary reconstruction. Using a 1-mm increase in MTSH as the cutoff value, our model showed excellent discriminative ability in predicting secondary ACL injury (AUC, 0.93; 95% CI, 0.86-0.99; sensitivity, 77.42%; specificity, 98.13%). These findings suggest that evaluating after reconstruction MTSH changes, particularly increases of ≥1 mm, may serve as a valuable risk assessment tool for secondary ACL injury.
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