Anterior cruciate ligament reconstruction: The role of lateral posterior tibial slope as a potential risk factor for failure

Background and aim of the work: Anterior cruciate ligament (ACL) reconstructions is an extremely frequent surgery. The analysis of anatomical factors is becoming increasingly important and the study of clinical, arthroscopic and radiological methods to evaluate and understand them aims to positively affect the patient’s outcome. This work aims to analytically analyze the anatomical factors that can influence the failure of an ACL reconstruction, to evaluate the data collected on a sample of patients undergoing ACL revision and compare them with those is present in the literature. Materials and Methods: At the Clinic of Orthopedic of Udine, between November 2018 and August 2020 were performed 47 revisions of the ACL. We analyzed MRI scans about Lateral Posterior Tibial Slope (LPTS). Patient surveys were analyzed by a single senior orthopedic surgeon who was blinded to patient history, age and gender. Results: Comparing with a value considered in the norm (LPTS estimated 6.5°) we see how the difference between the average LPTS values in the sample is significantly higher than the normal values (P <.0001). Dividing the simple according to sex, we notice that the LPTS in female patients is 11.8 while in male patients it is 8.7° (P <.005). Conclusion: The data collected show how an increased posterior lateral tibial slope can be correlated with a higher risk of ACL failure. The results are in line with what is present in the literature. Our analysis is absolutely preliminary, but it is intended to be the starting point of a path that allows us to think of the reconstruction of the ACL as an intervention to be planned more carefully based on the individual characteristics of the patient. (www.actabiomedica.it)