{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:00Z","timestamp":1789844520287,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>A higher posterior tibial slope (PTS) and malpositioning of bone tunnels are known risk factors for anterior cruciate ligament reconstruction (ACL reconstruction; ACLR) failure. However, it remains unclear whether these factors account for the mechanism of failure, whether traumatic or non\u2010traumatic. The purpose of this study was to analyze whether the ACL failure mechanism correlates with a higher PTS or non\u2010anatomical bone tunnels. It was hypothesized that a higher PTS and bone tunnel malposition are associated with non\u2010traumatic ACLR failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, all ACLR failures between 2015 and 2023 treated surgically at a single institution were included. The following factors were evaluated: sex, age at the time of revision surgery, PTS, anatomical versus non\u2010anatomical tunnel placement, concomitant pathologies and fixation techniques. PTS was measured using the Dejour technique. Tibial and femoral tunnels were analyzed according to the method described by St\u00e4ubli and Rauschning, and Bernard et al., respectively. A logistic regression analysis was performed to evaluate the effect of each factor on the mechanism of graft failure (traumatic vs. non\u2010traumatic).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 143 of 144 available patients (99.3%) were included. There was no statistically significant difference in patient demographics between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). There was no statistically significant association between the PTS or tunnel malposition and non\u2010traumatic ACLR failure (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). However, medial meniscus injuries were significantly more frequent in the non\u2010traumatic group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200953 [54.1%] vs.\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916 [35.6%];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034). The logistic regression showed no significant impact of any studied factor (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05) on the mechanism of ACLR failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients in our cohort with non\u2010traumatic ACLR failure did not demonstrate a higher PTS or a higher incidence of non\u2010anatomically positioned tibial or femoral tunnels compared with patients experiencing traumatic retears. However, non\u2010traumatic cases were associated with a higher prevalence of medial meniscus tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70699","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:21:57Z","timestamp":1777458117000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A higher posterior tibial slope and tunnel malposition do not predispose to non\u2010traumatic anterior cruciate ligament failure"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4098-2779","authenticated-orcid":false,"given":"Lorenz","family":"Fritsch","sequence":"first","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Willinger","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romed P.","family":"Vieieder","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bausch","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Mehl","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svenja","family":"H\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3193-6869","authenticated-orcid":false,"given":"Sebastian","family":"Siebenlist","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Runer","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07313-2"},{"key":"e_1_2_13_3_1","first-page":"332","article-title":"[Intraoperative and postoperative insertion control of anterior cruciate ligament\u2010plasty. A radiologic measuring method (quadrant method)]","volume":"99","author":"Bernard M","year":"1996","journal-title":"Unfallchirurg"},{"key":"e_1_2_13_4_1","first-page":"14","article-title":"Femoral insertion of the ACL. Radiographic quadrant method","volume":"10","author":"Bernard M","year":"1997","journal-title":"Am J Knee Surg"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231157377"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06607-7"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-022-09776-1"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-022-00461-3"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.76B5.8083263"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1530\/EOR-23-0085"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-021-04145-y"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231216364"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.99B6.BJJ-2016-0929.R2"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211049234"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520976147"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05360-2"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2016.01.043"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4797-y"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510378645"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290021801"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.11.032"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517741497"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.06.049"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01467915"},{"issue":"2013","key":"e_1_2_13_25_1","first-page":"47","article-title":"Revision anterior cruciate ligaments and the role of osteotomies","volume":"80","author":"Sun Y","year":"2022","journal-title":"Bull Hosp Joint Dis"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5237-3"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-020-00328-8"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1765-9"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06160-9"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2015.02.055"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513503288"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231178292"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06460-8"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211027170"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70699","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70699","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70699","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:12:57Z","timestamp":1789841577000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70699"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/jeo2.70699"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70699","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-01-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70699"}}