胫骨内侧后陡坡与双侧前交叉韧带损伤有关：与单侧病例的影像学比较

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-09-04 DOI:10.1002/jeo2.70424

Julien Druel, Paul Laidet, Apoorva Khajuria, Antoine Piercecchi, Jean-Noël Argenson, Christophe Jacquet, Fabio Sammartino, Matthieu Ollivier

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引用次数: 0

摘要

目的胫骨后斜度（PTS）在膝关节生物力学中起着关键作用，并可能影响前交叉韧带（ACL）断裂的风险及其重建的结果。我们假设与单侧重建相比，更陡的胫骨内侧后坡（MPTS）与双侧前交叉韧带重建的风险增加有关。本研究旨在通过影像学比较单侧ACL重建（uniACLR）和非同时双侧ACL重建（biACLR）患者的MPTS来验证这一假设。方法本研究纳入114例患者（单aclr 57例，双aclr 57例），根据年龄、性别、体重指数（BMI）和半月板损伤情况进行匹配。在标准化侧位x线片上测量MPTS。在关节镜下评估半月板、软骨和韧带损伤。统计分析包括单因素模型和多因素模型，显著性阈值为p <； 0.05。结果biACLR组患者的MPTS明显高于uniACLR组（平均±SD: 12.39°±2.74°vs 8.16°±1.67°；平均差4.23°，95%可信区间：3.35°-5.11°；p < 0.0001）。在半月板、软骨病变、移植物选择、外侧关节外肌腱固定术的使用或再手术率方面，组间无显著差异。亚组分析表明，较高的MPTS与半月板根撕裂特别相关。结论更陡的MPTS与双侧ACL重建显著相关，提示其可能是重复ACL损伤的解剖学危险因素。系统评估MPTS有助于识别对侧ACL损伤风险较高的患者，有助于手术计划和术后监测。证据水平III级，回顾性比较队列研究。

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Steeper medial posterior tibial slope is associated with bilateral ACL injuries: A radiographic comparison with unilateral cases

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Steeper medial posterior tibial slope is associated with bilateral ACL injuries: A radiographic comparison with unilateral cases

Purpose

The posterior tibial slope (PTS) plays a key role in knee biomechanics and may influence the risk of anterior cruciate ligament (ACL) rupture as well as the outcomes of its reconstruction. We hypothesised that a steeper medial posterior tibial slope (MPTS) would be associated with an increased risk of bilateral ACL reconstruction compared to unilateral reconstruction. This study aimed to test this hypothesis by comparing the MPTS between patients undergoing unilateral ACL reconstruction (uniACLR) and those requiring non-simultaneous bilateral ACL reconstruction (biACLR), using radiographic imaging.

Methods

This single-centre retrospective study included 114 patients (57 uniACLR, 57 biACLR), matched by age, gender, body mass index (BMI), and presence of meniscal injury. The MPTS was measured on standardised lateral radiographs. Meniscal, cartilage, and ligamentous injuries were evaluated arthroscopically. Statistical analyses included univariate and multivariate models, with a significance threshold of p < 0.05.

Results

Patients in the biACLR group demonstrated a significantly higher MPTS compared to the uniACLR group (mean ± SD: 12.39° ± 2.74° vs. 8.16° ± 1.67°; mean difference 4.23°, 95% confidence interval: 3.35°–5.11°; p < 0.0001). No significant differences were observed between groups in meniscal, cartilaginous lesions, graft selection, use of lateral extra-articular tenodesis, or reoperation rates. Subgroup analysis indicated that higher MPTS was particularly associated with meniscal root tears.

Conclusion

A steeper MPTS is significantly associated with bilateral ACL reconstruction, suggesting it may represent an anatomical risk factor for repeated ACL injuries. Systematic assessment of MPTS may help identify patients at higher risk of contralateral ACL injury, aiding in surgical planning and postoperative monitoring.