Findings from a study published online in The American Journal of Sports Medicine suggest that posterior tibial slope (PTS) of 12° or more may be the strongest predictor of repeat anterior cruciate ligament (ACL) injury, with the effect most pronounced in adolescents. 

The researchers conducted a prospective, case-control study of 200 consecutive patients who underwent isolated primary ACL reconstruction with hamstring tendon autograft. Among 179 patients available at 20-year follow-up, the researchers found that ACL graft rupture occurred in 37 patients, and 22 patients experienced contralateral ACL injury. Of participants with intact ACL grafts at 20 years, the researchers found that outcomes were not statistically different between adolescents and adults for the variables of International Knee Documentation Committee subjective score, return to preinjury activity level, current activity level, or degree of radiological degenerative change. Overall, ACL graft survival at 20 years was 86 percent for adults and 61 percent for adolescents, but ACL survival for adolescents with a PTS of ≥12° was 22 percent. Compared with adults with a PTS <12°, the hazard for ACL graft rupture was increased by 11x in adolescents with a PTS of ≥12°. Learn more...

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