Decreased Posterior Tibial Slope Does Not Affect Postoperative Posterior Knee Laxity After Double-Bundle Posterior Cruciate Ligament Reconstruction. 2019

Andrew S Bernhardson, and Nicholas N DePhillipo, and Zachary S Aman, and Mitchell I Kennedy, and Grant J Dornan, and Robert F LaPrade
The Steadman Clinic, Vail, Colorado, USA.

Recent clinical studies identified sagittal plane posterior tibial slope as a risk factor for increased postoperative laxity after single-bundle posterior cruciate ligament reconstruction (PCLR). To retrospectively compare the degree of posterior tibial slope and its effect on posterior tibial translation (PTT) after double-bundle (DB) PCLR. Our null hypothesis was that preoperative tibial slope would not be associated with graft laxity. Case series; Level of evidence, 4. Patients who underwent DB PCLR between 2010 and 2017 by a single surgeon were retrospectively analyzed. Measurements of posterior tibial slope were performed on lateral radiographs, and PTT was measured with pre- and postoperative kneeling stress radiographs. Simple and multiple linear regression was performed to estimate the unadjusted and adjusted effect of tibial slope on postoperative graft laxity, respectively. A total of 103 patients with posterior cruciate ligament tears and subsequent reconstructions were included. There was a significant reduction of the mean ± SD side-to-side difference in PTT between stress radiographs (preoperative, 10.6 ± 2.7 mm; postoperative, 1.5 ± 2.6 mm; mean difference, 9.1 mm; 95% CI, 8.4-9.8; P < .001). Linear regression analysis revealed no significant correlation between preoperative posterior tibial slope and the amount of side-to-side difference in PTT on postoperative stress radiographs obtained at a mean 18.5 months ( R = -0.115, P = .249). Combined ligament injury (beta = -1.01; 95% CI, -2.00 to -0.01; P = .047) was a significant independent predictor of decreased postoperative side-to-side difference in PTT. Graft laxity, determined by PTT in posterior kneeling stress radiographs, was not influenced by decreased posterior tibial slope after DB PCLRs. The observed results in the current study support the use of DB PCLR. Future studies should be conducted to compare the effect of tibial slope after SB PCLR and DB PCLR at long-term follow-up.

UI MeSH Term Description Entries
D007593 Joint Instability Lack of stability of a joint or joint prosthesis. Hypermobility, Joint,Instability, Joint,Laxity, Joint,Hypermobilities, Joint,Instabilities, Joint,Joint Hypermobilities,Joint Hypermobility,Joint Instabilities,Joint Laxities,Joint Laxity,Laxities, Joint
D007718 Knee Injuries Injuries to the knee or the knee joint. Injuries, Knee,Injury, Knee,Knee Injury
D007719 Knee Joint A synovial hinge connection formed between the bones of the FEMUR; TIBIA; and PATELLA. Superior Tibiofibular Joint,Joint, Knee,Joint, Superior Tibiofibular,Knee Joints,Superior Tibiofibular Joints,Tibiofibular Joint, Superior
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072229 Posterior Cruciate Ligament Reconstruction Rebuilding of the POSTERIOR CRUCIATE LIGAMENT to restore functional stability of the knee.

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