Low posterior tibial slope is associated with increased risk of PCL graft failure View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-01-14

AUTHORS

Philipp W. Winkler, Nyaluma N. Wagala, Sabrina Carrozzi, Ehab M. Nazzal, Michael A. Fox, Jonathan D. Hughes, Bryson P. Lesniak, Dharmesh Vyas, Stephen J. Rabuck, James J. Irrgang, Volker Musahl

ABSTRACT

PurposeTo evaluate the effect of posterior tibial slope (PTS) on patient-reported outcomes (PROs) and posterior cruciate ligament (PCL) graft failure after PCL reconstruction.MethodsPatients undergoing PCL reconstruction with a minimum 2-year follow-up were included in this retrospective cohort study. A chart review was performed to collect patient-, injury-, and surgery-related data. Medial PTS was measured on preoperative lateral radiographs. Validated PROs, including the International Knee Documentation Committee Subjective Knee Form, Knee injury and Osteoarthritis Outcome Score, Lysholm Score, Tegner Activity Scale, and Visual Analogue Scale for pain, were collected at final follow-up. A correlation analysis was conducted to assess the relationship between PTS and PROs. A logistic regression model was performed to evaluate if PTS could predict PCL graft failure.ResultsOverall, 79 patients with a mean age of 28.6 ± 11.7 years and a mean follow-up of 5.7 ± 3.3 years were included. After a median time from injury of 4.0 months, isolated and combined PCL reconstruction was performed in 22 (28%) and 57 (72%) patients, respectively. There were no statistically significant differences in PROs and PTS between patients undergoing isolated and combined PCL reconstruction (non-significant [n.s.]). There were no significant correlations between PTS and PROs (n.s.). In total, 14 (18%) patients experienced PCL graft failure after a median time of 17.5 months following PCL reconstruction. Patients with PCL graft failure were found to have statistically significantly lower PTS than patients without graft failure (7.0 ± 2.3° vs. 9.2 ± 3.3°, p < 0.05), while no differences were found in PROs (n.s.). PTS was shown to be a significant predictor of PCL graft failure, with a 1.3-fold increase in the odds of graft failure for each one-degree reduction in PTS (p < 0.05).ConclusionsThis study showed that PTS does not affect PROs after PCL reconstruction, but that PTS represents a surgically modifiable predictor of PCL graft failure.Level of evidenceIII. More... »

PAGES

3277-3286

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-021-06760-z

DOI

http://dx.doi.org/10.1007/s00167-021-06760-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1144648443

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35028674


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25 schema:description PurposeTo evaluate the effect of posterior tibial slope (PTS) on patient-reported outcomes (PROs) and posterior cruciate ligament (PCL) graft failure after PCL reconstruction.MethodsPatients undergoing PCL reconstruction with a minimum 2-year follow-up were included in this retrospective cohort study. A chart review was performed to collect patient-, injury-, and surgery-related data. Medial PTS was measured on preoperative lateral radiographs. Validated PROs, including the International Knee Documentation Committee Subjective Knee Form, Knee injury and Osteoarthritis Outcome Score, Lysholm Score, Tegner Activity Scale, and Visual Analogue Scale for pain, were collected at final follow-up. A correlation analysis was conducted to assess the relationship between PTS and PROs. A logistic regression model was performed to evaluate if PTS could predict PCL graft failure.ResultsOverall, 79 patients with a mean age of 28.6 ± 11.7 years and a mean follow-up of 5.7 ± 3.3 years were included. After a median time from injury of 4.0 months, isolated and combined PCL reconstruction was performed in 22 (28%) and 57 (72%) patients, respectively. There were no statistically significant differences in PROs and PTS between patients undergoing isolated and combined PCL reconstruction (non-significant [n.s.]). There were no significant correlations between PTS and PROs (n.s.). In total, 14 (18%) patients experienced PCL graft failure after a median time of 17.5 months following PCL reconstruction. Patients with PCL graft failure were found to have statistically significantly lower PTS than patients without graft failure (7.0 ± 2.3° vs. 9.2 ± 3.3°, p < 0.05), while no differences were found in PROs (n.s.). PTS was shown to be a significant predictor of PCL graft failure, with a 1.3-fold increase in the odds of graft failure for each one-degree reduction in PTS (p < 0.05).ConclusionsThis study showed that PTS does not affect PROs after PCL reconstruction, but that PTS represents a surgically modifiable predictor of PCL graft failure.Level of evidenceIII.
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31 schema:keywords Activity Scale
32 ConclusionsThis study
33 International Knee Documentation Committee Subjective Knee Form
34 Knee Form
35 Lysholm score
36 MethodsPatients
37 Osteoarthritis Outcome Score
38 PCL graft failure
39 PCL reconstruction
40 PurposeTo
41 ResultsOverall
42 Subjective Knee Form
43 Tegner activity scale
44 age
45 analog scale
46 analysis
47 chart review
48 cohort study
49 correlation
50 correlation analysis
51 data
52 differences
53 effect
54 failure
55 form
56 graft failure
57 increase
58 injury
59 knee injuries
60 lateral radiographs
61 logistic regression models
62 mean age
63 medial posterior tibial slope
64 median time
65 model
66 modifiable predictors
67 months
68 odds
69 outcome scores
70 outcomes
71 pain
72 patient-reported outcomes
73 patients
74 posterior tibial slope
75 predictors
76 preoperative lateral radiographs
77 radiographs
78 reconstruction
79 reduction
80 regression models
81 relationship
82 retrospective cohort study
83 review
84 risk
85 scale
86 scores
87 significant correlation
88 significant differences
89 significant predictors
90 slope
91 study
92 surgery-related data
93 tibial slope
94 time
95 visual analog scale
96 years
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