Anatomical risk mapping in ACL reconstruction: Radiological predictors of graft rerupture

IF 5.5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2026-09-29 Epub Date: 2025-10-27 DOI:10.1002/ksa.70119

Yusuf Sülek, Abdurrahman Demirhan, Yusuf Altuntaş, Enver İpek, Raffi Armağan, Osman Tuğrul Eren

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引用次数: 0

Abstract

Purpose

The aim of this study was to compare the anatomical parameters in patients with anterior cruciate ligament (ACL) rerupture after reconstruction with those without.

Methods

This retrospective study included patients who underwent primary ACL reconstruction using a quadrupled semitendinosus and gracilis tendon autograft between January 2017 and January 2021. Patients who required revision due to rerupture (n = 51) were then compared with age- and sex-matched controls without rerupture (n = 52). Radiological parameters were measured using standard lateral knee radiographs and magnetic resonance imaging (MRI). Measurements included femoral/tibial tunnel angles (FTA/TTA), tibial tunnel anteroposterior position (TTAPL), posterior tibial slope (PTS), lateral tibial plateau subluxation (LTPSu), lateral femoral condyle index (LFCI), as well as various other anatomical parameters such as tibial plateau morphology, meniscal pathology, and notch dimensions. Correlation and logistic regression analyses were performed.

Results

Significant differences were observed between the rerupture and control groups in TTA (71.7 ± 9.2 vs. 78.4 ± 12.8; p = 0.046), TTAPL (0.4 ± 0.1 vs. 0.4 ± 0.1; p = 0.043), LTPS (8.0 ± 4.7 vs. 5.8 ± 4.2; p = 0.015), MTPSu (2.1 ± 2.2 vs. 1.5 ± 2.4; p = 0.029), and LFCI (0.8 ± 0.1 vs. 0.7 ± 0.0; p < 0.001). In the final logistic regression model (χ² = 52.969; Nagelkerke R² = 0.536), TTA (OR = 0.93, p = 0.007), TTAPL (OR = 1.088, p = 0.088), LTS (OR = 1.116, p = 0.043), and LFCI (OR = 6.36 × 10¹⁰⁰, p = 0.001) remained as independent predictors. The overall classification accuracy of the model was 79.6%.

Conclusions

Several anatomical parameters—including a smaller TTA, more anterior tibial tunnel positioning, increased lateral tibial plateau slope, and a higher lateral femoral condyle index—were found to be independently associated with ACL graft rerupture. These radiological risk factors should be carefully evaluated during surgical planning and postoperative follow-up to reduce the likelihood of graft failure.

Level of Evidence

Level III, retrospective comparative study.

查看原文本刊更多论文

前交叉韧带重建的解剖学风险定位：移植物再破裂的放射学预测因素。

目的：本研究的目的是比较前交叉韧带（ACL）重建后再破裂患者的解剖学参数。方法：本回顾性研究纳入了2017年1月至2021年1月期间使用四重半腱肌和股薄肌腱自体移植进行初级ACL重建的患者。因再破裂而需要翻修的患者（n = 51）随后与年龄和性别匹配的无再破裂的对照组（n = 52）进行比较。使用标准侧膝x线片和磁共振成像（MRI）测量放射学参数。测量包括股骨/胫骨隧道角度（FTA/TTA）、胫骨隧道前后位置（TTAPL）、胫骨后斜度（PTS）、胫骨外侧平台半脱位（LTPSu）、股骨外侧髁指数（LFCI），以及各种其他解剖学参数，如胫骨平台形态、半月板病理和切迹尺寸。进行相关分析和逻辑回归分析。结果：TTA（71.7±9.2 vs. 78.4±12.8;p = 0.046）、TTAPL（0.4±0.1 vs. 0.4±0.1;p = 0.043）、LTPS（8.0±4.7 vs. 5.8±4.2;p = 0.015）、MTPSu（2.1±2.2 vs. 1.5±2.4;p = 0.029）和LFCI（0.8±0.1 vs. 0.7±0.0;p 100, p = 0.001）仍然是再破裂组与对照组之间的独立预测因子。该模型的总体分类准确率为79.6%。结论：几个解剖学参数，包括较小的TTA，更多的胫骨前隧道定位，胫骨外侧平台斜率增加，股骨外侧髁指数更高，被发现与ACL移植物再破裂独立相关。在手术计划和术后随访期间应仔细评估这些放射危险因素，以减少移植物失败的可能性。证据等级：III级，回顾性比较研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).