Dobarganes-Barlow F, Campos-Flores D, López-Flores A, Garcini-Munguía F, Guevara-Álvarez A, Gálvez-Romero J

Language: Spanish
References: 18
Page: 92-96
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ABSTRACT

Introduction: the tibial slope has been identified as one of the factors associated with graft failure after anterior cruciate ligament (ACL) reconstruction; however, its relationship with functional results has been little studied. The main purpose of this study is to determine the effect of the tibial slope on functional recovery in patients undergoing reconstruction of the anterior cruciate ligament. Material and methods: we included patients with a diagnosis of anterior cruciate ligament injury undergoing primary reconstruction, from May 2018 to May 2019, who had a complete radiographic and clinical record; also, the scores from questionnaires of the International Knee Documentation Committee (IKDC) and Lysholm scores were collected pre surgical procedures and throughout the one-year follow-up. The measurement of the tibial slope was performed in lateral knee X-rays from the electronic clinical record. A descriptive analysis of first intention was done, and to achieve the objectives, we compared 25 patients who had normal tibial slope that were selected randomly with 25 patients who had increased tibial slope. Results: a total of 98 patients were included, 73 had a normal tibial slope (equal to or less than 12 degrees) and 25 with an increased tibial slope (greater than 12 degrees), the average age in both groups was 28.43 years for the group with normal tibial slope and 28.26 for patients with increased tibial slope. Regarding the functional assessment, the IKDC and Lysholm scores at the end of the follow-up were better for patients with normal tibial slope. Graft failure was only identified in the group with increased tibial slope. On the other hand, the comparative analysis with the control group randomly selected who had normal tibial slope, showed a better functional result assessed by IKDC score at the end of the follow-up for the group with normal tibial slope. Conclusion: patients undergoing ACL reconstruction and increased Tibial Slope have an inferior functional result at one year of follow-up assessed by IKDC, when compared with patients with normal tibial slope.

REFERENCES

1. Sauer S, English R, Clatworthy M. The ratio of tibial slope and meniscal bone angle for the prediction of ACL reconstruction failure risk. Surg J (N Y). 2018; 4(3): e152-9. doi: 10.1055/s-0038-1668111.

2. Sauer S, Clatworthy M. The effect of medial tibial slope on anterior tibial translation and short-term ACL reconstruction outcome. Surg J (N Y). 2018; 4(3): e160-3. doi: 10.1055/s-0038-1669929.

3. Cooper JD, Wang W, Prentice HA, Funahashi TT, Maletis GB. The association between tibial slope and revision anterior cruciate ligament reconstruction in patients ≤21 years old: a matched case-control study including 317 revisions. Am J Sports Med. 2019; 47(14): 3330-8. doi: 10.1177/0363546519878436.

4. Hendrix ST, Barrett AM, Chrea B, Replogle WH, Hydrick JM, Barrett GR. Relationship between posterior-inferior tibial slope and bilateral noncontact ACL injury. Orthopedics. 2017; 40(1): e136-40. doi: 10.3928/01477447-20161013-06.

5. Schuster P, Geßlein M, Schlumberger M, Mayer P, Richter J. The influence of tibial slope on the graft in combined high tibial osteotomy and anterior cruciate ligament reconstruction. Knee. 2018; 25(4): 682-91. doi: 10.1016/j.knee.2018.04.007.

6. Bates NA, Mejia Jaramillo MC, Vargas M, McPherson AL, Schilaty ND, Nagelli CV, et al. External loads associated with anterior cruciate ligament injuries increase the correlation between tibial slope and ligament strain during in vitro simulations of in vivo landings. Clin Biomech (Bristol, Avon). 2019; 61: 84-94. doi: 10.1016/j.clinbiomech.2018.11.010.

7. Grassi A, Signorelli C, Urrizola F, Macchiarola L, Raggi F, Mosca M, et al. Patients with failed anterior cruciate ligament reconstruction have an increased posterior lateral tibial plateau slope: a case-controlled study. Arthroscopy. 2019; 35(4): 1172-82. doi: 10.1016/j.arthro.2018.11.049.

8. Bernhardson AS, Aman ZS, Dornan GJ, Kemler BR, Storaci HW, Brady AW, et al. Tibial slope and its effect on force in anterior cruciate ligament grafts: anterior cruciate ligament force increases linearly as posterior tibial slope increases. Am J Sports Med. 2019; 47(2): 296-302. doi: 10.1177/0363546518820302.

9. Dejour D, Pungitore M, Valluy J, Nover L, Saffarini M, Demey G. Tibial slope and medial meniscectomy significantly influence short-term knee laxity following ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2019; 27(11): 3481-9. doi: 10.1007/s00167-019-05435-0.

10. Wang D, Kent RN 3rd, Amirtharaj MJ, Hardy BM, Nawabi DH, Wickiewicz TL, et al. Tibiofemoral kinematics during compressive loading of the ACL-intact and ACL-sectioned knee: roles of tibial slope, medial eminence volume, and anterior laxity. J Bone Joint Surg Am. 2019; 101(12): 1085-92. doi: 10.2106/JBJS.18.00868.

11. Jaecker V, Drouven S, Naendrup JH, Kanakamedala AC, Pfeiffer T, Shafizadeh S. Increased medial and lateral tibial posterior slopes are independent risk factors for graft failure following ACL reconstruction. Arch Orthop Trauma Surg. 2018; 138(10): 1423-31. doi: 10.1007/s00402-018-2968-z.

12. Bojicic KM, Beaulieu ML, Imaizumi Krieger DY, Ashton-Miller JA, Wojtys EM. Association between lateral posterior tibial slope, body mass index, and ACL injury risk. Orthop J Sports Med. 2017; 5(2): 2325967116688664. doi: 10.1177/2325967116688664.

13. Lee CC, Youm YS, Cho SD, Jung SH, Bae MH, Park SJ, et al. Does posterior tibial slope affect graft rupture following anterior cruciate ligament reconstruction? Arthroscopy. 2018; 34(7): 2152-5. doi: 10.1016/j.arthro.2018.01.058.

14. Samuelsen BT, Aman ZS, Kennedy MI, Dornan GJ, Storaci HW, Brady AW, et al. Posterior medial meniscus root tears potentiate the effect of increased tibial slope on anterior cruciate ligament graft forces. Am J Sports Med. 2020; 48(2): 334-40. doi: 10.1177/0363546519889628.

15. Kiapour AM, Yang DS, Badger GJ, Karamchedu NP, Murray MM, Fadale PD, et al. Anatomic features of the tibial plateau predict outcomes of ACL reconstruction within 7 years after surgery. Am J Sports Med. 2019; 47(2): 303-11. doi: 10.1177/0363546518823556.

16. DePhillipo NN, Kennedy MI, Dekker TJ, Aman ZS, Grantham WJ, LaPrade RF. Anterior closing wedge proximal tibial osteotomy for slope correction in failed ACL reconstructions. Arthrosc Tech. 2019; 8(5): e451-7. doi: 10.1016/j.eats.2019.01.001.

17. Sabzevari S, Rahnemai-Azar AA, Shaikh HS, Arner JW, Irrgang JJ, Fu FH. Increased lateral tibial posterior slope is related to tibial tunnel widening after primary ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2017; 25(12): 3906-13. doi: 10.1007/s00167-017-4435-8.

18. Rahnemai-Azar AA, Abebe ES, Johnson P, Labrum J, Fu FH, Irrgang JJ, et al. Increased lateral tibial slope predicts high-grade rotatory knee laxity pre-operatively in ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2017; 25(4): 1170-6. doi: 10.1007/s00167-016-4157-3.

EVIDENCE LEVEL

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