ArticleOrthopaedic journal of sports medicine2026
Return-to-Sports Rates After Anterior Cruciate Ligament Reconstruction with High-Grade Impaction Fracture of the Posterolateral Tibial Plateau.
Article in Orthopaedic journal of sports medicine, 2026. 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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Abstract
Background: High-grade fracture of the posterolateral tibial plateau (PLTP) has been reported to increase bone loss, which in turn is associated with residual rotational instability and impaired function after anterior cruciate ligament (ACL) reconstruction. Purpose: To investigate whether high-grade impaction fracture in PLTP is associated with the rate of return to sports (RTS) after ACL reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively analyzed data from patients with complete ACL tears between December 2018 and June 2022. Inclusion criteria included primary ACLR with autologous hamstring reconstruction, standard preoperative magnetic resonance imaging (MRI) evaluation, and at least 2 years of postoperative follow-up. In contrast to bone contusions, a high-grade impaction fracture in PLTP is defined as subchondral or cortical bone displacement in this area involving the articular surface. Based on whether or not there were high-grade impaction fractures seen on the preoperative MRI, patients were divided into 2 groups: high-grade fracture and control group. Patients were followed up after surgery to assess their level of RTS, Tegner score, Lysholm score, and recovery time. The chi-square test was used to compare the differences in the RTS rate between the 2 groups. Results: Among 190 patients, 34 patients (17.9%) were in the high-grade group, while 156 patients (82.1%) were in the control group. Among the main outcomes, the high-grade fracture knee group performed worse in return to any sport (Tegner score ≥5) (71% vs 88.9%; Conclusion: The results of this study showed that high-grade impaction fracture of PLTP was associated with the rate of RTS after ACLR, mainly in the rate of return to any sport and level 1/2 (cutting) sports. Accordingly, the rehabilitation strategies and priorities for such patients should be adjusted to compensate for the impact.
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