The Impact of Posterior Tibial Slope and Static Anterior Tibial Translation on ACL Graft Rupture Rates After Hamstring Autograft Reconstruction With Lateral Extra-articular Tenodesis

Despite the addition of an LET, almost 20% of patients undergoing ACLR with hamstring tendon autografts experienced graft rupture when PTS was ≥12°. When combined with an increased SATT (≥5 mm), the graft rupture rate rose to 26%. In contrast, no graft ruptures were observed in patients with a PTS <9°. These findings emphasize the importance of evaluating PTS and SATT individually rather than systematically performing LET.