Decreased posterior tibial slope is a risk factor for primary posterior cruciate ligament rupture and posterior cruciate ligament reconstruction failure: A systematic review

Author:

Nedaie Soroush1ORCID,Vivekanantha Prushoth1ORCID,O'Hara Kaylin1,Slawaska‐Eng David2,Cohen Dan2,Abouali Jihad3,Hoshino Yuichi4,Nagai Kanto4,Johnson Jansen2,de SA Darren2ORCID

Affiliation:

1. Michael DeGroote School of Medicine McMaster University Hamilton Ontario Canada

2. McMaster University Medical Center Division of Orthopaedic Surgery Hamilton Ontario Canada

3. Department of Orthopaedic Surgery University of Toronto Toronto Ontario Canada

4. Department of Orthopaedic Surgery Kobe University Graduate School of Medicine Kobe Hyogo Japan

Abstract

AbstractPurposeTo determine bony knee morphological factors associated with primary posterior cruciate ligament (PCL) rupture or PCL graft failure after PCL reconstruction.MethodsThree databases, namely MEDLINE, PubMed and EMBASE, were searched on 30th May 2023. The authors adhered to the PRISMA and R‐AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data such as receiver operating characteristic curve parameters, as well as p‐values for comparisons of values between patients with PCL pathology and control patients, were recorded.ResultsNine studies comprising 1054 patients were included. Four studies reported that patients with PCL injury had flatter medial posterior tibial slopes (MTS) than controls, with mean values of 4.3 (range: 3.0–7.0) and 6.5 (range: 5.0–9.2) degrees, respectively. Two studies reported an MTS cutoff value ranging below 3.90–3.93° being a significant risk factor for primary PCL rupture or PCL graft failure. Two studies reported that shallow medial tibial depths were associated with primary PCL rupture, with mean values of 2.1 (range: 2.0–2.2) and 2.6 (range: 2.4–2.7) mm in PCL injury and control groups, respectively. Stenotic intercondylar notches and femoral condylar width were not consistently associated with PCL injuries.ConclusionDecreased MTS is associated with primary PCL rupture and graft failure after PCL reconstruction with values below 3.93° being considered as a significant risk factor. Less common risk factors include shallow medial tibial depth, while femoral condylar width and parameters with regards to the intercondylar notch, such as notch width, notch width index and intercondylar notch volume, demonstrated conflicting associations with primary or secondary PCL injuries.Level of EvidenceLevel III.

Publisher

Wiley

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