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

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

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.

Figures and Tables

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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.

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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.

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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.

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Table 1
Patient's Data
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Values are presented as mean±standard deviation or number. PTS, posterior tibial slope.

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Table 2
Comparison of Graft Tension and Synovial Coverage at Second Look Arthroscopy
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Values are presented as number (%). Round off the numbers to the nearest hundredths.

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Table 3
Comparison of Clinical Results
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Values are presented as mean±standard deviation or number (%). PTS, posterior tibial slope; op, operative.

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Table 4
Comparison of Stability according to Arthroscopic Finding
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Values are presented as mean±standard deviation or number (%). ACL, anterior cruciate ligament; op, operative.

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