Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture?

Okan Ateş; Ahsen Oğul

doi:10.54005/geneltip.1647003

EN TR

Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture?

Öz

Backrounds/Aims: Despite the improvements in Anterior cruciate ligament recontruction (ACLR) surgery, results of revision surgeries are not satisfactory. Risk factors involved in ACLR are currently being studied to reduce re-injuries. In this study, the relationship between posterior tibial slope angle (PTSA) and rupture after primary and revision surgery was investigated. Materials and Methosds: Patients over 18 years of age who underwent primary ACLR (primary group), patients with re-rupture (revision group) and individuals without any ligament injury (control group) were included in the study. Knee joint images of the participants were obtained by retrospective archive search. The posterior tibial slope angles in the included knee radiographs were measured using the anterior tibial cortex method. Results: The study evaluated knee joint images of 124 patients in the primary group, 39 patients in the revision group and 100 participants in the control group. Intra-observer and inter-observer reliability of PTSA measurements was found to be appropriate. A statistically significant difference was observed between the mean tibial slope angle measurement of the control, primary and revision groups. (p=0,0001). It was found that the risk of primary anterior cruciate ligament (ACL) injury and ACL re-rupture for an individual with PTSA>11.4 was 7.6 times and 9.58 times higher, respectively, than for an individual with PTSA<11.4°. Conclusion: Higher PTSA was observed to be an anatomical risk factor for primary and secondary ACL injuries. Patients with higher PTSA should be evaluated for additional risk factors and slope-reducing surgeries should be applied to these patients when necessary.

Anahtar Kelimeler

Anterior cruciate ligament, Tibial slope angle, Graft failure, Reconstruction, Revision surgery.

Tibial Eğim Açısının Artması Ön Çapraz Bağ Rekonstrüksiyonunda Rüptür Riskini Artırır mı?

Öz

Amaç: Ön çapraz bağ rekonstrüksiyonu (ÖÇBR) cerrahisindeki gelişmelere rağmen revizyon cerrahilerinin sonuçları tatmin edici değildir. ÖÇBR'de yer alan risk faktörleri şu anda yeniden yaralanmaları azaltmak için incelenmektedir. Bu çalışmada, posterior tibial eğim açısı (PTSA) ile primer ve revizyon cerrahisi sonrası meydana gelen rüptür arasındaki ilişki incelenmiştir. Gereç ve Yöntem: Primer ÖÇBR geçiren 18 yaş üstü hastalar (primer grup), rerüptür olan hastalar (revizyon grubu) ve herhangi bir bağ yaralanması olmayan kişiler (kontrol grubu) çalışmaya dahil edilmiştir. Katılımcıların diz eklemi görüntüleri retrospektif arşiv aramasıyla elde edilmiştir. Dahil edilen diz radyografilerindeki posterior tibial eğim açıları anterior tibial korteks yöntemi kullanılarak ölçülmüştür. Bulgular: Çalışmada primer gruptaki 124 hastanın, revizyon grubundaki 39 hastanın ve kontrol grubundaki 100 katılımcının diz eklemi görüntüleri değerlendirilmiştir. PTSA ölçümlerinin gözlemci içi ve gözlemciler arası güvenilirliğinin uygun olduğu bulunmuştur. Kontrol, primer ve revizyon gruplarının ortalama tibial eğim açısı ölçümü arasında istatistiksel olarak anlamlı bir fark gözlendi. (p=0,0001). PTSA>11,4 olan bir bireyde primer ön çapraz bağ (ÖÇB) yaralanması ve ÖÇB tekrar kopması riskinin sırasıyla PTSA<11,4° olan bir bireye göre 7,6 kat ve 9,58 kat daha yüksek olduğu bulundu. Sonuç: Daha yüksek PTSA'nın primer ve sekonder ÖÇB yaralanmaları için anatomik bir risk faktörü olduğu gözlemlendi. Daha yüksek PTSA'ya sahip hastalar ek risk faktörleri açısından değerlendirilmeli ve gerektiğinde bu hastalara eğim azaltıcı cerrahiler uygulanmalıdır

Anahtar Kelimeler

Ön çapraz bağ, Tibial eğim açısı, Greft yetmezliği, Rekonstrüksiyon, Revizyon cerrahisi.

Kaynakça

1. Cirdi Y, Ergün S, Başcı O, Karahan M. Ön çapraz bağ rekonstrüksiyonu revizyonu. In: Taşer ÖF, Mahiroğulları M, Karahan M, Taşkıran E, Emin B, editors. Diz eklemi bağ ve tendon sorunları. İstanbul; 2016. p. 189–201.
2. Ahmed I, Salmon L, Roe J, Pinczewski L. The long-term clinical and radiological outcomes in patients who suffer recurrent injuries to the anterior cruciate ligament after reconstruction. Bone Joint J. 2017;99B(3):337–43.
3. Napier RJ, Garcia E, Devitt BM, Feller JA, Webster KE. Increased Radiographic Posterior Tibial Slope Is Associated With Subsequent Injury Following Revision Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med. 2019;7(11):2325967119879373.
4. Cruz CA, Mannino BJ, Pike A, Thoma D, Lindell K, Kerbel YE, et al. Increased posterior tibial slope is an independent risk factor of anterior cruciate ligament reconstruction graft rupture irrespective of graft choice. J. ISAKOS. 2022;
5. Zee MJM, Keizer MNJ, Dijkerman L, van Raaij JJAM, Hijmans JM, Diercks RL. The correlation between posterior tibial slope and dynamic anterior tibial translation and dynamic range of tibial rotation. J Exp Orthop. 2021;8(1):1–8.
6. Salmon LJ, Heath E, Akrawi H, Roe JP, Linklater J, Pinczewski LA. 20-Year Outcomes of Anterior Cruciate Ligament Reconstruction With Hamstring Tendon Autograft: The Catastrophic Effect of Age and Posterior Tibial Slope. Am J Sports Med. 2017;46(3):531–43.
7. Gwinner C, Janosec M, Wierer G, Wagner M, Weiler A. Graft Survivorship After Anterior Cruciate Ligament Reconstruction Based on Tibial Slope. Am J Sports Med. 2021;49(14):3802–8.
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12. Liu Z, Jiang J, Yi Q, Teng Y, Liu X, He J, et al. An increased posterior tibial slope is associated with a higher risk of graft failure following ACL reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2022;30(7):2377–87.
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Ayrıntılar

Birincil Dil

İngilizce

Konular

Ortopedi

Bölüm

Araştırma Makalesi

Yazarlar

Okan Ateş ^*
0000-0002-4534-4101
Türkiye

Ahsen Oğul
0000-0001-7379-0750
Türkiye

Yayımlanma Tarihi

28 Ekim 2025

Gönderilme Tarihi

25 Şubat 2025

Kabul Tarihi

12 Ağustos 2025

Yayımlandığı Sayı

Yıl 2025 Cilt: 35 Sayı: 5

DOI

https://doi.org/10.54005/geneltip.1647003

IZ

https://izlik.org/JA99RP67GB

APA

Ateş, O., & Oğul, A. (2025). Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture? Genel Tıp Dergisi, 35(5), 854-862. https://doi.org/10.54005/geneltip.1647003

AMA

1.Ateş O, Oğul A. Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture? Genel Tıp Derg. 2025;35(5):854-862. doi:10.54005/geneltip.1647003

Chicago

Ateş, Okan, ve Ahsen Oğul. 2025. “Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture?”. Genel Tıp Dergisi 35 (5): 854-62. https://doi.org/10.54005/geneltip.1647003.

EndNote

Ateş O, Oğul A (01 Ekim 2025) Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture? Genel Tıp Dergisi 35 5 854–862.

IEEE

[1]O. Ateş ve A. Oğul, “Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture?”, Genel Tıp Derg, c. 35, sy 5, ss. 854–862, Eki. 2025, doi: 10.54005/geneltip.1647003.

ISNAD

Ateş, Okan - Oğul, Ahsen. “Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture?”. Genel Tıp Dergisi 35/5 (01 Ekim 2025): 854-862. https://doi.org/10.54005/geneltip.1647003.

JAMA

1.Ateş O, Oğul A. Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture? Genel Tıp Derg. 2025;35:854–862.

MLA

Ateş, Okan, ve Ahsen Oğul. “Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture?”. Genel Tıp Dergisi, c. 35, sy 5, Ekim 2025, ss. 854-62, doi:10.54005/geneltip.1647003.

Vancouver

1.Okan Ateş, Ahsen Oğul. Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture? Genel Tıp Derg. 01 Ekim 2025;35(5):854-62. doi:10.54005/geneltip.1647003

Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.

Does an Increase in the Tibial Slope Angle Increase the Risk of Anterior Cruciate Ligament Re-rupture?

Öz

Anahtar Kelimeler

Tibial Eğim Açısının Artması Ön Çapraz Bağ Rekonstrüksiyonunda Rüptür Riskini Artırır mı?

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

Kaynak Göster