Paper - WANFANG MED ONLINE

You Position: Home > Paper

Are failures of anterior cruciate ligament reconstruction associated with steep posterior tibial slopes? A case control study

( views:77, downloads:12 )

Author:: No author available

Journal Title:: Chinese Medical Journal

Issue:: 14

DOI:: 10.3760/cma.j.issn.0366-6999.20132756

Key Word:: anterior cruciate ligament reconstruction;medial posterior tibial slope;lateral posterior tibial slope;correlation;failure

Abstract： Background Recently,increasing number of literature has identified the posterior tibial slope (PTS) as one of the risk factors of primary anterior cruciate ligament (ACL) injury.However,few studies conceming the association between failure of ACL reconstruction (ACLR) and PTS have been published.The objective of this study was to explore the association between the failure of ACLR and PTS at a minimum of two years follow-up.Methods Two hundred and thirty eight eligible patients from June 2009 to October 2010 were identified from our database.A total of 20 failure cases of ACLR and 20 randomly selected controls were included in this retrospective study.The demographic data and the results of manual maximum side-to-side difference with KT-1000 arthrometer at 30° of knee flexion and pivot-shift test before the ACLR and at the final follow-up were collected.The medial and lateral PTSs were measured using the magnetic resonance imaging (MRI) scan,based on Hudek's measurement.A comparison of PTS between the two groups was performed.Results The overall failure rate of the present study was 8.4％.Of the 40 participants,the mean medial PTS was 4.1°±3.2° and the mean lateral PTS was 4.6°±2.6°.The medial PTS of the ACLR failure group was significantly steeper than the control group (3.5°±2.5° vs.6.1°±2.1°,P=0.000).Similarly,the lateral PTS of the ACLR failure group was significantly steeper than the control group (2.9°±2.1 ° vs.5.5°±3.0°,P=0.006).For medial PTS ≥5°,the odds ratio of ACLR failure was 6.8 (P=0.007); for lateral PTS ≥5°,the odds ratio of ACLR failure was 10.8 (P=0.000).Conclusion Both medial and lateral PTS were significantly steeper in failures of ACLR than the control group.Medial or lateral PTS ≥5° was a new risk factor of ACLR failure.

Reference

[1]Jiao Chen,AO Ying-fang,LIU Ping,etc.Anterior cruciate ligament reconstruction using the bone-posterior cruciate ligament-bone allograft[J].2013,(4).
[2]MA Yong,AO Ying-fang,YU Jia-kuo,etc.Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery[J].2013,(2).
[3]Waller,A.,Leys,T.,Salmon,L.,etc.Clinical results and risk factors for reinjury 15 years after anterior cruciate ligament reconstruction: A prospective study of hamstring and patellar tendon grafts[J].2012,40(3).
[4]Brandon ML,Haynes PT,Bonamo JR,etc.The association between posterior-inferior tibial slope and anterior cruciate ligament insufficiency.[J].2006,22(8).
[5]Mauro,C.S.,Brucker,P.U.,Feucht,M.J.,etc.The role of the tibial slope in sustaining and treating anterior cruciate ligament injuries[J].2013,21(1).
[6]E.HeftiMD,W.Müller,R.P.Jakob,etc.Evaluation of knee ligament injuries with the IKDC form[J].1993,1(3).
[7]Webb,J.M.,Salmon,L.J.,Leclerc,E.,etc.Posterior tibial slope and further anterior cruciate ligament injuries in the anterior cruciate ligament-reconstructed patient[J].2013,41(12).
[8]Reichel,H.,Bauer,J.,Dürselen,L.,etc.Increasing posterior tibial slope does not raise anterior cruciate ligament strain but decreases tibial rotation ability[J].2013,28(3).
[9]Magnussen,R.A.,Garrett,W.E.,West,R.L.,etc.Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft[J].2012,28(4).
[10]Crawford, S. N.,Waterman, M. B.,Lubowitz, J. H..Long-Term Failure of Anterior Cruciate Ligament Reconstruction[J].2013,29(9).
[11]Burdin G,Jouve F,Dubrana F,etc.Causes for failure of ACL reconstruction and influence of meniscectomies after revision.[J].2011,19(2).
[12]Hudek R,Schmutz S,Regenfelder F.Novel measurement technique of the tibial slope on conventional MRI.[J].2009,467(8).
[13]Shao Q,Manal K,MacLeod TD,etc.Estimation of ligament loading and anterior tibial translation in healthy and ACL-deficient knees during gait and the influence of increasing tibial slope using EMG-driven approach.[J].2011,39(1).
[14]Hohmann E,Bryant A,Reaburn P,etc.Does posterior tibial slope influence knee functionality in the anterior cruciate ligament-deficient and anterior cruciate ligament-reconstructed knee?[J].2010,26(11).
[15]Hudek R,Koch PP,Regenfelder F,etc.Is noncontact ACL injury associated with the posterior tibial and meniscal slope?[J].2011,469(8).
[16]Feng,H.,Li,X.,Zhang,J.,etc.Anterior cruciate ligament reconstruction with remnant preservation: A prospective, randomized controlled study[J].2012,40(12).
[17]MarcheggianiMuccioli,G.M.,Vaccari,V.,Marcacci,M.,etc.Combined ACL reconstruction and closing-wedge HTO for varus angulated ACL-deficient knees[J].2013,21(4).
[18]Wright RW,Dunn WR,Spindler KP,etc.Ipsilateral Graft and Contralateral ACL Rupture at Five Years or More Following ACL Reconstruction: A Systematic Review.[J].2011,93/A(12).
[19]Palmer ML,Ashton Miller JA,Oh YK,etc.The relationship between anterior tibial acceleration, tibial slope, and ACL strain during a simulated jump landing task.[J].2011,93/A(14).
[20]Stijak L,Herzog RF,Schai P.Is there an influence of the tibial slope of the lateral condyle on the ACL lesion?: A case-control study.[J].2008,16(2).
[21]Lipps,D.B.,Wilson,A.M.,Ashton-Miller,J.A.,etc.Evaluation of different methods for measuring lateral tibial slope using magnetic resonance imaging[J].2012,40(12).
[22]Shelburne KB,Kim HJ,Sterett WI,etc.Effect of posterior tibial slope on knee biomechanics during functional activity.[J].2011,29(2).
[23]Giffin JR,Vogrin TM,Zantop T,etc.Effects of increasing tibial slope on the biomechanics of the knee.[J].2004,32(2).
[24]Hashemi J,Chandrashekar N,Mansouri H,etc.Shallow medial tibial plateau and steep medial and lateral tibial slopes: new risk factors for anterior cruciate ligament injuries.[J].2010,38(1).
[25]Suero,E.M.,Bosscher,M.R.F.,Wickiewicz,T.L.,etc.Effect of tibial slope on the stability of the anterior cruciate ligament-deficient knee[J].2012,20(8).
[26]Kamien,P.M.,Hydrick,J.M.,Barrett,G.R.,etc.Age, graft size, and tegner activity level as predictors of failure in anterior cruciate ligament reconstruction with hamstring autograft[J].2013,41(8).
[27]Bortolletto J,Chambat P,Fayard JM,etc.The influence of the tibial slope and the size of the intercondylar notch on rupture of the anterior cruciate ligament.[J].2011,93/B(11).