{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:02:05Z","timestamp":1780581725707,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"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>To investigate whether posterior tibial slope (PTS) is associated with failure after posterior cruciate ligament reconstruction (PCLR) in a cohort of patients undergoing isolated PCLR and PCL\u2010based multiligament knee injuries (MLKI) reconstruction. The hypothesis was that (1) a reduced PTS is a factor affecting PCLR failures in isolated PCLR, but (2) it is not in the context of PCL\u2010based MLKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A multicentric retrospective study was conducted across four high\u2010volume knee surgery centres. Patients were contacted to assess the occurrence of additional surgical procedures, knee stability and satisfaction using the simple knee value (SKV). PTS of medial compartment was measured on lateral radiographs. Survival analysis was performed using the Kaplan\u2013Meier method with failure as the endpoint (revision PCL reconstruction, persistent posterior instability documented by a positive posterior drawer test), and Cox regression was used to evaluate the association between PTS and failure. Patients were stratified according to tertiles of PTS distribution (low \u22647\u00b0, intermediate 7\u00b0\u201310\u00b0, high &gt;10\u00b0). Additionally, PTS was compared between failure and non\u2010failure groups using the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test (\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 173 patients met the inclusion criteria; 24 (13.9%) were considered failures. The overall survival rate was 86.1%, 96% at 2 years, and 70% at 15 years. PTS was slightly higher in patients who failed compared to those who did not (9.1\u2009\u00b1\u20092.3\u00b0 vs. 8.0\u2009\u00b1\u20093.2\u00b0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). However, no significant differences in survivorship were observed across PTS tertiles. Kaplan\u2013Meier and Cox regression analyses did not demonstrate a significant association between PTS and failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PTS was not associated with failure after PCLR. These findings indicate that sagittal tibial alignment alone may have a limited role in determining reconstruction survivorship and do not support routine correction of PTS in primary PCLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70472","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:08:27Z","timestamp":1780578507000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Decreased posterior tibial slope is not a risk factor for posterior cruciate ligament reconstruction failure: A multicentric analysis of 173 cases"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1693-2809","authenticated-orcid":false,"given":"Nicola","family":"Pizza","sequence":"first","affiliation":[{"name":"Knee and Arthroscopy Unit, ICATME Departament de Ci\u00e8ncies Morfol\u00f2giques, Universitat Autonoma de Barcelona Departament de Cirurgia, Universitat Autonoma de Barcelona Hospital Universitari Dexeus Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Perelli","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit, ICATME Departament de Ci\u00e8ncies Morfol\u00f2giques, Universitat Autonoma de Barcelona Departament de Cirurgia, Universitat Autonoma de Barcelona Hospital Universitari Dexeus Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Grassi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, DIBINEM Universit di Bologna Bologna Italy"},{"name":"Clinica Ortopedica e Traumatologica II IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelangelo","family":"Delmedico","sequence":"additional","affiliation":[{"name":"Orthopaedics and Traumatology Service ASST Papa Giovanni XXIII di Bergamo Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Zappal\u00e0","sequence":"additional","affiliation":[{"name":"Orthopaedics and Traumatology Service ASST Papa Giovanni XXIII di Bergamo Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Simon\u2010Sanchez","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit, ICATME Departament de Ci\u00e8ncies Morfol\u00f2giques, Universitat Autonoma de Barcelona Departament de Cirurgia, Universitat Autonoma de Barcelona Hospital Universitari Dexeus Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Andrea","family":"Lucidi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, DIBINEM Universit di Bologna Bologna Italy"},{"name":"Clinica Ortopedica e Traumatologica II IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliano","family":"Iba\u00f1ez","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit, ICATME Departament de Ci\u00e8ncies Morfol\u00f2giques, Universitat Autonoma de Barcelona Departament de Cirurgia, Universitat Autonoma de Barcelona Hospital Universitari Dexeus Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Zaffagnini","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, DIBINEM Universit di Bologna Bologna Italy"},{"name":"Clinica Ortopedica e Traumatologica II IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Monllau","sequence":"additional","affiliation":[{"name":"Knee and Arthroscopy Unit, ICATME Departament de Ci\u00e8ncies Morfol\u00f2giques, Universitat Autonoma de Barcelona Departament de Cirurgia, Universitat Autonoma de Barcelona Hospital Universitari Dexeus Barcelona 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