Influence of Posterior Tibial Slope on Stability and Second-Look Arthroscopic Findings after Anterior Cruciate Ligament Reconstruction

Hee-Gon Park; Jae-Sung Yoo; Chang-Hwan Hwang

doi:10.4055/jkoa.2013.48.4.266

Journal List > J Korean Orthop Assoc > v.48(4) > 1013236

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Park, Yoo, and Hwang: Influence of Posterior Tibial Slope on Stability and Second-Look Arthroscopic Findings after Anterior Cruciate Ligament Reconstruction

Original Article

Journal of the Korean Orthopaedic Association 2013; 48(4): 266-272.

Published online: 28 August 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.4.266

Influence of Posterior Tibial Slope on Stability and Second-Look Arthroscopic Findings after Anterior Cruciate Ligament Reconstruction

Hee-Gon Park, M.D., Jae-Sung Yoo, M.D., Chang-Hwan Hwang, M.D.

Department of Orthopaedic Surgery, Dankook University Hospital, Cheonan, Korea.

Correspondence to: Hee-Gon Park, M.D. Department of Orthopaedic Surgery, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan 330-715, Korea. TEL: +82-41-550-3954, FAX: +82-41-556-3238, osdku@dankook.ac.kr

Received 2 May 2013 Revised 6 June 2013 Accepted 2 July 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to analyze the influence of posterior tibial slope on stability in clinical and second-look arthroscopic evaluation after anterior cruciate ligament (ACL) reconstruction.

Materials and Methods

From 2000 to 2011, 124 patients who underwent ACL reconstruction using an allogaft were enrolled in this study. A posterior tibial slope between 0° and 4° was found in 28 patients (group A), between 5° and 9° in 64 patients (group B), and greater than 10° in 32 patients (group C). We evaluated stability using the Lachman test and a KT-2000 arthrometer. In second-look arthroscopy, grafted tendons were evaluated based on the tension, rupture, and synovial coverage.

Results

In clinical evaluation for stability, mean KT-2000 arthrometer and Lachman test at last follow-up showed no statistically significant differences depending on posterior tibial slope. Second-look arthroscopic findings showed no statistically significant difference between groups A and B (p=0.91). However, statistically significant relations were observed between groups A and C (p=0.03), and between groups B and C (p=0.02).

Conclusion

The results of this study suggest that patients who underwent ACL reconstruction with higher posterior tibial slope (≥10°) have more lax tension in second-look arthroscopy, but not in clinical stability tests.

Keywords: anterior cruciate ligament, reconstruction, stability, posterior slope

Figures and Tables

Figure 1

Posterior tibial slope (PTS) measurement. The PTS angle is defined as 90° minus the angle made by the intersection of the line along the longitudinal axis of the tibia and the slope of the medial tibial plateau.

Figure 2

Arthroscopic classification of grafts based on the tension. (A) Taut tension of the grafted tendon. (B) Lax tension of the grafted tendon. (C) Partial tear of grafted tension.

Figure 3

Arthroscopic classification of grafts based on synovialization. (A) Good synovialization of the grafted tendon. (B) Half synovialization of the grafted tendon. (C) Poor synovialization of grafted tension.

Table 1

Patient's Data

Values are presented as mean±standard deviation or number. PTS, posterior tibial slope.

Table 2

Comparison of Graft Tension and Synovial Coverage at Second Look Arthroscopy

Values are presented as number (%). Round off the numbers to the nearest hundredths.

Table 3

Comparison of Clinical Results

Values are presented as mean±standard deviation or number (%). PTS, posterior tibial slope; op, operative.

Table 4

Comparison of Stability according to Arthroscopic Finding

Values are presented as mean±standard deviation or number (%). ACL, anterior cruciate ligament; op, operative.

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