ArticleJournal of experimental orthopaedics2026
Posterior tibial slope is associated with ACL status rather than demographic factors: A cohort of 1406 patients.
Article in Journal of experimental orthopaedics, 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
Purpose: To determine whether posterior tibial slope (PTS), measured on lateral radiographs using the proximal anatomical tibial axis defined by two circles, is independently associated with anterior cruciate ligament (ACL) injury status or influenced by age, sex and body mass index (BMI). Methods: A retrospective single-centre cohort study included all 1406 consecutive eligible patients operated between January 2010 and September 2024: 857 ACL-intact controls undergoing medial patellofemoral ligament reconstruction, 498 patients with primary ACL rupture and 51 patients with ACL re-rupture. PTS was measured on standardized lateral radiographs using the proximal anatomical tibial axis defined by two circles. Multivariable linear regression evaluated the independent associations of ACL status, age, sex and BMI with PTS. Receiver operating characteristic (ROC) analyses assessed discrimination of ACL injury. Results: Mean PTS was 7.3 ± 3.1° in controls, 9.9 ± 3.1° in patients with primary ACL rupture and 10.9 ± 3.5° in patients with ACL re-rupture ( Conclusion: PTS was independently associated with ACL injury and ACL re-rupture, whereas age, sex and BMI had no clinically meaningful independent influence. PTS should be interpreted as one component of a multifactorial anatomical risk profile rather than as a standalone screening test. Level of Evidence: Level III, retrospective comparative cohort study.
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