What question did this study set out to answer?

The study aims to investigate the relationship between posterior tibial slope (PTS) and graft survival in anterior cruciate ligament (ACL) reconstruction with lateral extra-articular tenodesis (LET).

April 24, 2026

Association Between Posterior Tibial Slope and Graft Survival in High-Risk Anterior Cruciate Ligament Reconstruction With Lateral Extra-articular Tenodesis

Key Points

The study aims to investigate the relationship between posterior tibial slope (PTS) and graft survival in anterior cruciate ligament (ACL) reconstruction with lateral extra-articular tenodesis (LET).
Analyzed graft outcomes in high-risk ACL reconstruction patients with varying levels of posterior tibial slope.
Compared graft failure rates between groups with and without lateral extra-articular tenodesis.
Evaluated the direct correlation between PTS values and rerupture rates.
Found that higher posterior tibial slope is linked to increased graft failure rates in both treatment groups.
Demonstrated that moderate PTS values correlate with lower failure risks when lateral extra-articular tenodesis is applied.
Revealed steeper slopes amplify the risk of reruptures, reducing LET's protective effect.

Abstract

PTS was independently associated with graft failure in both groups. Although LET was associated with lower failure probabilities within a moderate slope range, increasing PTS values were linked to a progressively higher risk of reruptures in both groups. The association between a steeper slope and failure observed in the ACLR with LET group suggests that an elevated PTS may attenuate the relative protective effect of LET.

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