No association detected between posterior tibial slope, static anterior tibial translation and medial meniscus repair failure after anterior cruciate ligament reconstruction

Abstract Purpose This study aimed to evaluate the influence of the posterior tibial slope (PTS) and static anterior tibial translation (SATT) on the success of medial meniscus (MM) repair performed concomitantly with anterior cruciate ligament reconstruction (ACLR). Methods In this retrospective study, all patients who underwent primary ACLR using hamstring autograft combined with isolated MM repair between January 2014 and December 2017, and a minimum follow‐up of 6 years, were included. Patients who had undergone meniscectomy or lateral meniscus repair were excluded. Demographic data, PTS, SATT, dynamic anterior tibial translation (DATT), the need for reoperation (at the same location) for MM repair failure (MMRF), and time to failure were recorded. Comparative analyses were performed using thresholds of 12° for PTS and 5 mm for SATT. Univariate logistic regression analyses were used to identify independent risk factors for MMRF. Results Among the 148 patients included, 14 (9.4%) experienced a MMRF at a mean of 24 ± 16 months post‐operatively (range 7–60 months). Twenty‐eight percent of patients had undergone concomitant lateral extra‐articular tenodesis (LET). There were no significant differences between the MMRF and non‐failure groups in terms of age, sex, presence of LET, PTS, SATT or DATT. Patients with PTS ≥ 12° (odds ratio, 2.9; 95% confidence interval, 0.8–11.6; p = 0.11) or SATT ≥ 5 mm did not demonstrate a higher rate of MMRF. No variable from the univariate analysis met the criteria for inclusion in the multivariate analysis. Limited number of MMRF events increase potential risk of type II error. Conclusion No statistically significant association was detected between PTS, SATT, DATT, age or the presence of LET and MMRF after hamstring ACLR. However, larger studies are needed, particularly in high‐slope subgroups. Increased PTS or SATT alone should not discourage MM repair in the setting of ACLR. Level of Evidence Level III, retrospective case–control study.