{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:53:11Z","timestamp":1776174791175,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"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":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Posterolateral tibial plateau fractures (PLTFs) have been increasingly studied due to their association with soft tissue injuries around the knee. This prospective study aimed to determine whether the presence of PLTFs is associated with soft tissue injuries around the knee and correlates with an increased preoperative quantitative pivot shift (PS). It was hypothesized that the presence of PLTFs is associated with greater clinical and quantitative PS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective registry study was conducted, and patients who underwent primary unilateral anterior cruciate ligament (ACL) reconstruction at a single institution were included. The PS test was preoperatively performed in general anaesthesia and quantified using the PIVOT iPad application. The anterior translation of the lateral tibia plateau (ATLT) was measured in both the injured and uninjured knee, and the side\u2010to\u2010side difference was calculated. The PS test was additionally graded according to International Knee Documentation Committee (IKDC) criteria. PLTFs were classified according to Bernholt's classification. Injuries to the Kaplan fibres (KFs), anterolateral complex (ALC) and the menisci were evaluated on preoperative magnetic resonance imaging (MRI) scans. Student's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test was used to compare means, and chi\u2010square was used to test for correlations. Statistical significance was set to\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 142 patients with a mean age of 30.9\u2009\u00b1\u200911.7 years were included. PLTFs were present in 94 (66%) of patients. The presence of PLTFs was associated with concomitant injuries to the KF (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), ALC (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), medial and lateral meniscus (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The presence or the severity of a PLTF did not increase the ATLT during quantitative PS or IKDC PS grading (n.s.).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PLTFs are associated with concomitant injuries to the ALC and both menisci, indicating that they occur within a broader pattern of structural knee damage. However, these injuries do not appear to contribute to a greater preoperative PS. The presence of PLTFs should alert surgeons to the high probability of associated injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, diagnostic studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70393","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:05:46Z","timestamp":1776171946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Posterolateral tibial plateau fractures are associated with anterolateral complex injuries of the knee in primary ACL injury"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1574-4157","authenticated-orcid":false,"given":"Lukas","family":"Willinger","sequence":"first","affiliation":[{"name":"Department of Sports Orthopedics Technical University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp Wilhelm","family":"Winkler","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopedics Technical University Munich Munich Germany"},{"name":"Department for Orthopedics and Traumatology Kepler University Hospital GmbH, Johannes Kepler University Linz Linz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelius","family":"Packheiser","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopedics Technical University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Achtnich","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopedics Technical University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Siebenlist","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopedics Technical University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Runer","sequence":"additional","affiliation":[{"name":"Department of Sports Orthopedics Technical University Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1007\/s00167-021-06543-6","article-title":"Anterolateral complex injuries occur in the majority of \u2018isolated\u2019 anterior cruciate ligament ruptures","volume":"30","author":"Balendra G","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671211000038","article-title":"Association of ligamentous laxity, male sex, chronicity, meniscal injury, and posterior tibial slope with a high\u2010grade preoperative pivot shift: a post hoc analysis of the stability study","volume":"9","author":"Batty LM","year":"2021","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1177\/0363546518820302","article-title":"Tibial slope and its effect on force in anterior cruciate ligament grafts: anterior cruciate ligament force increases linearly as posterior tibial slope increases","volume":"47","author":"Bernhardson AS","year":"2019","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/BPO.0000000000002270","article-title":"The incidence of posterolateral tibial plateau and central lateral femoral condylar impaction fractures in a pediatric and young adult population","volume":"43","author":"Bernholt DL","year":"2023","journal-title":"J Pediatr Orthop"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1177\/0363546519895239","article-title":"Incidence of displaced posterolateral tibial plateau and lateral femoral condyle impaction fractures in the setting of primary anterior cruciate ligament tear","volume":"48","author":"Bernholt DL","year":"2020","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1177\/0363546519893709","article-title":"Morphologic variants of posterolateral tibial plateau impaction fractures in the setting of primary anterior cruciate ligament tear","volume":"48","author":"Bernholt DL","year":"2020","journal-title":"Am J Sports Med"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1177\/0363546520932912","article-title":"High\u2010grade posterolateral tibial plateau impaction fractures in the setting of a primary anterior cruciate ligament tear are correlated with an increased preoperative pivot shift and inferior postoperative outcomes after anterior cruciate ligament reconstruction","volume":"48","author":"Bernholt 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collateral ligament injuries in \u2018isolated\u2019 anterior cruciate ligament ruptures: a long overlooked injury","volume":"30","author":"Willinger L","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_28_1","first-page":"1","article-title":"Lateral meniscus injuries have more impact on pivot shift than anterolateral complex injuries in anterior cruciate ligament\u2010injured knees","author":"Willinger L","year":"2025","journal-title":"Knee Surg Sports Traumatol Arthrosc"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70393","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70393","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70393","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T13:05:49Z","timestamp":1776171949000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70393"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":27,"alternative-id":["10.1002\/ksa.70393"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70393","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]},"assertion":[{"value":"2025-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ksa.70393"}}