We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Effect of Posterior Tibial Slopes on Graft Survival Rates at 10 Years After Primary Single-Bundle Posterior Cruciate Ligament Reconstruction.
- Authors
Yoon, Kyoung Ho; Lee, Jong-Hwan; Kim, Sang-Gyun; Park, Jae-Young; Lee, Hee-Sung; Kim, Sang Jin; Kim, Yoon-Seok
- Abstract
Background: Recent biomechanical studies have reported that stress on the posterior cruciate ligament (PCL) graft increases as the posterior tibial slope (PTS) decreases (flattened) in knees with single-bundle (SB) and double-bundle PCL reconstruction. Clinical studies of SB PCL reconstruction have shown that a flattened PTS is associated with a lesser reduction in posterior tibial translation. There is no long-term study on the clinical outcomes and graft survival rates of SB PCL reconstruction based on the medial and lateral PTSs measured on magnetic resonance imaging. Hypothesis: Flattened medial and lateral PTSs are associated with poor clinical outcomes and graft survival rates at a minimum 10-year follow-up after SB PCL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: In this cohort study, we retrospectively reviewed 46 patients (mean age, 28.8 ± 9.9 years) who underwent primary SB PCL reconstruction between 2000 and 2009. They were followed up for a minimum of 10 years. The medial and lateral PTSs were measured on preoperative magnetic resonance imaging. As a previous study reported that a steeper medial or lateral PTS showed a higher risk of anterior tibial translation at thresholds of 5.6° and 3.8°, respectively, the patients were divided into 2 groups based on the cutoff values of both the medial (≤5.6° vs >5.6°) and lateral (≤3.8° vs >3.8°) PTSs. Clinical scores (International Knee Documentation Committee subjective score, Lysholm score, and Tegner activity score), radiological outcomes (side-to-side difference [SSD] on stress radiography and osteoarthritis progression), and graft survival rates were compared between the groups at the last follow-up. Results: All clinical scores and the progression of osteoarthritis demonstrated no significant difference between the 2 subgroups of both the medial and lateral PTS groups. The mean SSD on stress radiography after SB PCL reconstruction was significantly greater in patients with a medial PTS ≤5.6° than in patients with a medial PTS >5.6° (8.4 ± 3.9 vs 5.1 ± 2.9 mm, respectively; P =.030), while the lateral PTS subgroups after SB PCL reconstruction demonstrated no significant difference. The minimum 10-year graft survival rate was significantly lower in patients with a medial PTS ≤5.6° (68.4% vs 92.6%, respectively; P =.029) and a lateral PTS ≤3.8° (50.0% vs 91.7%, respectively; P =.001). Conclusion: A flattened medial PTS (≤5.6°) was associated with an increased SSD on stress radiography, and both flattened medial (≤5.6°) and lateral (≤3.8°) PTSs resulted in lower graft survival rates at a minimum 10-year follow-up after primary SB PCL reconstruction.
- Subjects
SOUTH Korea; POSTERIOR cruciate ligament surgery; LOG-rank test; PLASTIC surgery; GRAFT survival; RETROSPECTIVE studies; MAGNETIC resonance imaging; MANN Whitney U Test; FISHER exact test; TREATMENT effectiveness; T-test (Statistics); OSTEOARTHRITIS; DESCRIPTIVE statistics; CHI-squared test; KAPLAN-Meier estimator; INTRACLASS correlation; TIBIA; DATA analysis software; LONGITUDINAL method
- Publication
American Journal of Sports Medicine, 2023, Vol 51, Issue 5, p1194
- ISSN
0363-5465
- Publication type
Article
- DOI
10.1177/03635465231156621