{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:51:34Z","timestamp":1792083094945,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine whether posterior tibial slope (PTS), measured on lateral radiographs using the proximal anatomical tibial axis defined by two circles, is independently associated with anterior cruciate ligament (ACL) injury status or influenced by age, sex and body mass index (BMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective single\u2010centre cohort study included all 1406 consecutive eligible patients operated between January 2010 and September 2024: 857 ACL\u2010intact controls undergoing medial patellofemoral ligament reconstruction, 498 patients with primary ACL rupture and 51 patients with ACL re\u2010rupture. PTS was measured on standardized lateral radiographs using the proximal anatomical tibial axis defined by two circles. Multivariable linear regression evaluated the independent associations of ACL status, age, sex and BMI with PTS. Receiver operating characteristic (ROC) analyses assessed discrimination of ACL injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean PTS was 7.3\u2009\u00b1\u20093.1\u00b0 in controls, 9.9\u2009\u00b1\u20093.1\u00b0 in patients with primary ACL rupture and 10.9\u2009\u00b1\u20093.5\u00b0 in patients with ACL re\u2010rupture (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Intraobserver and interobserver reliability were good to excellent (intraclass correlation coefficient [ICC]\u2009=\u20090.88) and moderate to good (ICC\u2009=\u20090.81). Multivariable analysis demonstrated that ACL injury status was the dominant independent determinant of PTS. Compared with controls, primary ACL rupture and ACL re\u2010rupture were associated with 2.52\u00b0 and 3.63\u00b0 greater PTS, respectively (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Age showed a minimal inverse association (\u22120.019\u00b0 per year; 95% confidence interval [CI], \u22120.036\u00b0 to \u22120.003\u00b0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), whereas sex and BMI were not independently associated with PTS. ROC analysis identified a Youden\u2010derived value of 10\u00b0, with an area under the curve of 0.731 (95% CI, 0.705\u20130.758) for primary ACL rupture and 0.791 (95% CI, 0.741\u20130.841) for ACL re\u2010rupture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PTS was independently associated with ACL injury and ACL re\u2010rupture, whereas age, sex and BMI had no clinically meaningful independent influence. PTS should be interpreted as one component of a multifactorial anatomical risk profile rather than as a standalone screening test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective comparative cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70890","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:47:10Z","timestamp":1787068030000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Posterior tibial slope is associated with ACL status rather than demographic factors: A cohort of 1406 patients"],"prefix":"10.1002","volume":"13","author":[{"given":"Julien","family":"Druel","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Assistance Publique des H\u00f4pitaux de Marseille, Institute for Locomotion, H\u00f4pital Sainte Marguerite, St Marguerite Hospital Aix\u2010Marseille University Marseille France"},{"name":"Department of Biomechanics APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romir","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Assistance Publique des H\u00f4pitaux de Marseille, Institute for Locomotion, H\u00f4pital Sainte Marguerite, St Marguerite Hospital Aix\u2010Marseille University Marseille France"},{"name":"Department of Biomechanics APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Jacquet","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Assistance Publique des H\u00f4pitaux de Marseille, Institute for Locomotion, H\u00f4pital Sainte Marguerite, St Marguerite Hospital Aix\u2010Marseille University Marseille France"},{"name":"Department of Biomechanics APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyes","family":"Chaal","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Assistance Publique des H\u00f4pitaux de Marseille, Institute for Locomotion, H\u00f4pital Sainte Marguerite, St Marguerite Hospital Aix\u2010Marseille University Marseille France"},{"name":"Department of Biomechanics APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Piercecchi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Assistance Publique des H\u00f4pitaux de Marseille, Institute for Locomotion, H\u00f4pital Sainte Marguerite, St Marguerite Hospital Aix\u2010Marseille University Marseille France"},{"name":"Department of Biomechanics APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-0873","authenticated-orcid":false,"given":"Matthieu","family":"Ollivier","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Assistance Publique des H\u00f4pitaux de Marseille, Institute for Locomotion, H\u00f4pital Sainte Marguerite, St Marguerite Hospital Aix\u2010Marseille University Marseille France"},{"name":"Department of Biomechanics APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion Aix\u2010Marseille University Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07313-2"},{"issue":"3","key":"e_1_2_13_3_1","first-page":"195","article-title":"Evaluation of methods for radiographic measurement of the tibial slope. 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