Is Posterior Tibial Slope and Mechanism of Failure Crucial for an Anatomically Reconstructed Primary Hamstring Graft Anterior Cruciate Ligament?

• Published in: Journal of arthroscopy and joint surgery Vol. 9; no. 4; pp. 163 - 168
• Main Authors: Supreeth, Sam, Al Barwani, Aliya, Al Manei, Khalid, Al Ghanami, Suwailim, Shanmugasundaram, Saseendar, Kotnoor, Vijay Kumar
• Format: Journal Article
• Language: English
• Published: 01.10.2022
• ISSN: 2542-6001; 2214-9635
• DOI: 10.4103/jajs.jajs_87_22

Purpose Native anterior cruciate ligament (ACL) failure is multifactorial with tibial slope identified as a crucial risk factor. The aim was to examine relation between lateral posterior tibial slope (LTPS) and failed ACL primary reconstruction by negating the associated risk factors such as tunnel position, gender, and graft types based on the mechanism of failure. Materials and Methods Our retrospective study included 102 patients, diagnosed as failed primary anterior cruciate ligament reconstruction (ACLR). The LPTS was measured on lateral radiographs and the tunnel position assessed by magnetic resonance imaging on both femoral, tibial side by two musculoskeletal radiologists. We compared the slopes in patients based on their mechanism of failure. Results The mean LPTS in patients with anatomically placed tunnel (9.28° ± 3.5°; range, 4°–18°) was significantly higher than the rest (7.7° ± 2.9°; range, 3°–15°; P = 0.01). There was a significant association of higher tibial slope in graft rupture due to contact mechanism of failure ( P = 0.02). LPTS was not significantly associated with noncontact mechanism of failure. Conclusion LTPS is a significant risk factor for failure in hamstring graft reconstructed ACL patients with optimally placed tunnels. LPTS ≥10° increases the risk of hamstring graft failure due to contact mechanism.