{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:05:01Z","timestamp":1785229501347,"version":"3.55.0"},"reference-count":70,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"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 determine whether preoperative posterior tibial slope (PTS) and intercondylar notch morphology are associated with arthroscopic anterior cruciate ligament primary repair (ACLPR) failure 2\u20135 years postoperatively, and to explore the association of the difference between medial and lateral PTS (MPTS and LPTS), and magnetic resonance imaging (MRI) versus radiograph slope agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective secondary analysis included a prospectively collected, single\u2010surgeon cohort of patients aged \u226518 years who underwent ACLPR for selected proximal anterior cruciate ligament (ACL) tears between 2008 and 2021 with 2\u20135 years of follow\u2010up. MPTS, LPTS and anterior\/posterior notch width (aNW and pNW) were quantified on preoperative MRI; PTS was additionally measured in a radiograph subset. Failure was defined as objective knee laxity (side\u2010to\u2010side difference\u2009\u2265\u20093\u2009mm, Lachman\u2009\u2265\u20092 or pivot\u2010shift\u2009\u2265\u20092) and\/or patient\u2010reported symptomatic instability, including telemedicine follow\u2010up. Associations with failure were assessed using univariable and multivariable logistic regression and exploratory analyses included receiver operating characteristic\/area under the curve and time\u2010to\u2010failure analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 249 patients (51.4% female; mean age 39.4\u2009\u00b1\u200910.8 years) with median follow\u2010up of 3.2 years (interquartile range 2.4\u20135.0), 24 (9.6%) met failure definition. After adjustment for age and suture augmentation, increased PTS was associated with failure per 1\u00b0 increase (MPTS: odds ratio [OR] 1.62; 95% confidence interval [CI] 1.35\u20131.96; LPTS: OR 1.35; 95% CI 1.17\u20131.55; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while older age was associated with lower odds of failure. In exploratory analysis, directed \u0394PTS (MPTS\u2013LPTS) was associated with failure (adjusted OR 1.27; 95% CI 1.07\u20131.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). Intercondylar notch width was not associated with failure. MRI and radiographic\u2010based slope measurements correlated (MPTS\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.706; LPTS\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.590; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this selected cohort of patients undergoing arthroscopic ACLPR, greater MPTS and LPTS and younger age were associated with higher odds of failure at 2\u20135 years, while notch width was not. These findings suggest that PTS may help contextualise risk when counselling patients considered for ACLPR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70543","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T08:44:37Z","timestamp":1785228277000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Increased posterior tibial slope is associated with failure after anterior cruciate ligament primary repair"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5328-4103","authenticated-orcid":false,"given":"Christian","family":"Arras","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"},{"name":"Department of Trauma and Orthopaedic Surgery University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian M.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"},{"name":"Department of Trauma Surgery Orthopaedics and Sports Traumatology, BG Klinikum Hamburg Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6949-6433","authenticated-orcid":false,"given":"Sebastian","family":"Conner\u2010Rilk","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"},{"name":"Medical University of Vienna Vienna Austria"},{"name":"OCM \u2010 Orthopedic Surgery Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik R.","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Radiology New York Presbyterian Hospital\u2010Weill Cornell New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioia","family":"Nash","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana C.","family":"Monteleone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel C.","family":"Goodhart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9559-757X","authenticated-orcid":false,"given":"Gregory S.","family":"DiFelice","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Hospital for Special Surgery, NewYork\u2010Presbyterian, Weill Medical College of Cornell University New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1177\/0363546513508376","article-title":"Anterior cruciate ligament injury and radiologic 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