J Korean Orthop Assoc.  2013 Aug;48(4):266-272.

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

• Park HG
• Yoo JS
• Hwang CH

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 0degrees and 4degrees was found in 28 patients (group A), between 5degrees and 9degrees in 64 patients (group B), and greater than 10degrees 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 (> or =10degrees) have more lax tension in second-look arthroscopy, but not in clinical stability tests.

Keyword

anterior cruciate ligament; reconstruction; stability; posterior slope

MeSH Terms

Anterior Cruciate Ligament
Anterior Cruciate Ligament Reconstruction
Arthroscopy
Follow-Up Studies
Humans
Rupture
Tendons
Transplants

Figure

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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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