Sauer Steffen, Clatworthy Mark
Department of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark.
Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand.
Surg J (N Y). 2018 Sep 10;4(3):e160-e163. doi: 10.1055/s-0038-1669929. eCollection 2018 Jul.
Increased tibial slope has been shown to be associated with higher anterior cruciate ligament (ACL) reconstruction failure rate. Little is known about the correlation of tibial slope and anterior tibial translation in ACL deficient and reconstructed knees as well as the correlation of tibial slope and ACL reconstruction outcome. The purpose of this study was to investigate the correlation of tibial slope with anterior tibial translation and ACL reconstruction outcome. It is hypothesized that increased medial tibial slope is associated with increased anterior tibial translation in the ACL deficient knee. Medial tibial slope is neither expected to affect anterior tibial translation in the ACL reconstructed knee nor short-term ACL reconstruction outcome. A cohort of 104 patients with unilateral isolated ACL deficiency undergoing hamstring ACL reconstruction by a single surgeon between 2002 and 2004 was followed up prospectively. Preoperative data were collected including patient demographics, time to surgery, subjective and objective International Knee Documentation Committee (IKDC) outcome scores, as well as manual maximum anterior tibial translation measured with the KT-1000 measuring instrument. Medial tibial slope was assessed on long lateral X-rays using the method described by Dejour and Bonnin (1994). Intraoperative data were collected including meniscal integrity; postoperative data were collected at 1-year follow-up including manual maximum anterior tibial translation (KT-1000 measured), and subjective and objective IKDC scores. A significant positive correlation was seen between medial tibial slope in ACL deficient knees and KT-1000-measured anterior tibial translation ( = 0.24; = 0.003). The positive relationship increased when meniscal integrity was factored in ( = 0.33; < 0.001). No significant correlation was seen between medial or lateral meniscal integrity and KT-1000-measured anterior tibial translation ( = -18; = 0.06). No significant correlation was seen between KT-1000-measured anterior tibial translation and time to surgery. One year postoperatively, 82 patients were assessed, while 26 patients were lost to follow-up; no significant correlation was found between increased medial tibial slope and poor ACL reconstruction outcome measured by post-ACL reconstruction anterior tibial translation (KT-1000) or subjective and objective IKDC scores. Increased medial tibial slope is associated with increased (KT-1000 measured) anterior tibial translation in ACL deficient knees. No significant correlation is found between increased medial tibial slope and poor short-term ACL reconstruction outcome.
胫骨坡度增加已被证明与前交叉韧带（ACL）重建失败率较高相关。关于ACL缺失和重建膝关节中胫骨坡度与胫骨前移的相关性以及胫骨坡度与ACL重建结果的相关性，目前所知甚少。
本研究的目的是调查胫骨坡度与胫骨前移及ACL重建结果之间的相关性。研究假设为，ACL缺失膝关节中内侧胫骨坡度增加与胫骨前移增加相关。内侧胫骨坡度预计既不会影响ACL重建膝关节中的胫骨前移，也不会影响ACL重建的短期结果。
对2002年至2004年间由同一位外科医生进行腘绳肌ACL重建的104名单侧孤立性ACL缺失患者进行了前瞻性随访。收集术前数据，包括患者人口统计学信息、手术时间、主观和客观的国际膝关节文献委员会（IKDC）结果评分，以及使用KT - 1000测量仪测量的手动最大胫骨前移。使用Dejour和Bonnin（1994年）描述的方法在长侧位X射线上评估内侧胫骨坡度。收集术中数据，包括半月板完整性；术后1年随访时收集的数据包括手动最大胫骨前移（KT - 1000测量）以及主观和客观的IKDC评分。
在ACL缺失膝关节的内侧胫骨坡度与KT - 1000测量的胫骨前移之间发现显著正相关（r = 0.24；P = 0.003）。纳入半月板完整性因素后，正相关关系增强（r = 0.33；P < 0.001）。内侧或外侧半月板完整性与KT - 1000测量的胫骨前移之间未发现显著相关性（r = - 0.18；P = 0.06）。KT - 1000测量的胫骨前移与手术时间之间未发现显著相关性。术后1年，对82例患者进行了评估，26例患者失访；在ACL重建后胫骨前移（KT - 1000）或主观和客观IKDC评分所衡量的内侧胫骨坡度增加与不良ACL重建结果之间未发现显著相关性。
ACL缺失膝关节中内侧胫骨坡度增加与（KT - 1000测量的）胫骨前移增加相关。内侧胫骨坡度增加与不良短期ACL重建结果之间未发现显著相关性。
