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Lateral meniscal slope negatively affects post-operative anterior tibial translation at 1 year after primary anterior cruciate ligament reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to assess the correlation between posterior tibial slope and meniscal slope over postoperative anterior tibial translation during the first 18 months after primary anterior cruciate ligament (ACL) reconstruction. The main hypothesis was that PTS and MS would be positively correlated with post-operative ATT-SSD after ACL reconstruction.

Methods

Patients (28 males and 15 females) with confirmed ACL tears were selected from an in-house registry and included if they were over 16 years old, had primary ACL-reconstruction and healthy contralateral knee. Patients meeting one of the following criteria were excluded: previous knee surgeries, intraarticular fractures, associated ligamentous lesions, previous or concomitant meniscectomy or extraarticular procedures. Lateral posterior tibial slope, medial posterior tibial slope, lateral meniscal slope and medial meniscal slope were measured using preoperative MRIs. The side-to-side-difference in anterior tibial translation was evaluated 9–18 months postoperatively.

Results

Forty-three patients were included, (28 males/15 females; mean age 25 ± 8 years). Mean postoperative anterior tibial translation was 1.0 ± 1.1 mm at a mean time of 12 ± 1 months. Mean slope values were: lateral posterior tibial slope 4.7° ± 2.2°, medial posterior tibial slope 4.0° ± 2.8°, lateral meniscal slope 3.0° ± 2.2° and medial meniscal slope 2.0° ± 2.8°. The anterior tibial translation was significantly correlated with lateral meniscal slope (r = 0.63; p < 0.01). For each 1° increase in lateral meniscal slope, a 0.3 mm 95% CI [0.2, 0.4] (p < 0.01) increase in anterior tibial translation was observed. A lateral meniscal slope greater or equal to 4.0° was estimated as optimal threshold for increased risk of abnormal side-to-side difference in postoperative anterior tibial translation (≥ 1.2 mm).

Conclusion

The lateral meniscal slope was positively correlated to side-to-side difference in anterior tibial translation after primary ACL reconstruction. A lateral meniscal slope greater or equal to 4.0° was detected as threshold for an increased risk of abnormal side-to-side difference in postoperative anterior tibial translation in patients who underwent primary ACL reconstruction. This confirms that soft tissue slopes have an impact on the outcomes after reconstructive surgery.

Level of evidence III.

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Authors and Affiliations

  1. UOS Chirurgia Articolare del Ginocchio, I Clinica Ortopedica, ASST Gaetano Pini-CTO, 1 Piazza Cardinal Ferrari, 20122, Milan, Italy

    Daniele Tradati

  2. Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg-Clinique d’Eich, 78 Rue d’Eich, 1460, Luxembourg, Luxembourg

    Caroline Mouton, Wouter Beel & Romain Seil

  3. Department of Physiotherapy, Centre Hospitalier de Luxembourg-Clinique d’Eich, 78 Rue d’Eich, 1460, Luxembourg, Luxembourg

    Anouk Urhausen

  4. Sports Medicine Research Laboratory, Luxembourg Institute of Health, 76 Rue d’Eich, 1460, Luxembourg, Luxembourg

    Anouk Urhausen & Romain Seil

  5. Department of Sports Medicine, Centre Hospitalier de Luxembourg-Clinique d’Eich, 78 Rue d’Eich, 1460, Luxembourg, Luxembourg

    Christian Nührenbörger

  6. Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science, Luxembourg, Luxembourg

    Caroline Mouton & Romain Seil

Authors
  1. Daniele Tradati
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  2. Caroline Mouton
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All authors contributed equally to the study.

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Correspondence to Romain Seil.

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The authors’ declare that they have no conflict of interest.

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National Ethics Committee for Research (N°201101/05).

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All patients signed an informed consent to participate in the study.

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Tradati, D., Mouton, C., Urhausen, A. et al. Lateral meniscal slope negatively affects post-operative anterior tibial translation at 1 year after primary anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 28, 3524–3531 (2020). https://doi.org/10.1007/s00167-020-06021-5

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