{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:15:29Z","timestamp":1790010929738,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"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>Increased passive anterior tibial subluxation (PATS) has been observed in patients with failed anterior cruciate ligament (ACL) reconstruction (ACLR). However, whether primary PATS is associated with future risk of graft failure and how PATS evolves over time remain unclear. This study aims to determine whether PATS measured at the time of the primary ACL injury is associated with graft failure and to characterize the longitudinal changes in PATS among patients with and without graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted on patients who underwent primary ACLR between January 2019 and December 2023. A total of 131 patients with graft failure were propensity score\u2010matched to 131 controls with intact grafts at a minimum 48\u2010month follow\u2010up (age, 28.9\u2009\u00b1\u20097.7 years; 61 females [23.3%]). Primary magnetic resonance imaging (MRI) evaluation was performed for all patients before primary ACLR. Secondary MRI evaluation was performed before revision surgery for the failure group (median [interquartile range {IQR}], 31.0 [19.1\u201358.0] months) and at 24 months post\u2010operatively for the control group (median [IQR], 24.9 [23.9\u201327.4] months). Multivariable logistic regression and receiver operating characteristic curve analysis were performed to evaluate factors associated with graft failure. Multivariable linear regressions were performed to identify factors associated with longitudinal changes in PATS between the primary and secondary MRI evaluations. Statistical analyses were performed using R software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significantly higher lateral (L\u2010PATS) and medial (M\u2010PATS) PATS at both the primary and secondary MRI evaluations were observed in the failed ACLR group compared with the control group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Patients with graft failure demonstrated significant longitudinal progression of PATS compared to those with intact grafts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Primary L\u2010PATS (odds ratio [OR], 1.166;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lateral tibial slope (LTS) (OR, 1.193;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were identified as factors independently associated with graft failure, demonstrating moderate discriminative ability (area under the curve [AUC], 0.682 and 0.668). Graft failure, female sex and medial meniscus injury were independently associated with longitudinal increases in PATS (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increased L\u2010PATS measured at the time of the primary ACL injury was associated with an increased risk of graft failure. Patients who experienced graft failure demonstrated significant longitudinal increases in both L\u2010PATS and M\u2010PATS compared to those with intact ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70607","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:57:22Z","timestamp":1790009842000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between passive anterior tibial subluxation and anterior cruciate ligament reconstruction failure"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-798X","authenticated-orcid":false,"given":"Yi\u2010tian","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3056-0937","authenticated-orcid":false,"given":"Wei\u2010li","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010fei","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin\u2010feng","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai\u2010peng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai\u2010jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9305-6158","authenticated-orcid":false,"given":"Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0504-7169","authenticated-orcid":false,"given":"Jian\u2010quan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine Peking University Third Hospital Beijing China"},{"name":"Beijing Key Laboratory of Sports Injuries Beijing China"},{"name":"Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"3","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1177\/03635465010290030301","article-title":"Fixed tibial subluxation after successful anterior cruciate ligament reconstruction","volume":"29","author":"Almekinders LC","year":"2001","journal-title":"Am J Sports 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controls","volume":"52","author":"Cance N","year":"2024","journal-title":"Am J Sports Med"},{"issue":"8","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.1016\/j.arthro.2018.03.038","article-title":"Risk factors for abnormal anteroposterior knee laxity after primary anterior cruciate ligament reconstruction","volume":"34","author":"Cristiani R","year":"2018","journal-title":"Arthroscopy"},{"issue":"11","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"3481","DOI":"10.1007\/s00167-019-05435-0","article-title":"Tibial slope and medial meniscectomy significantly influence short\u2010term knee laxity following ACL reconstruction","volume":"27","author":"Dejour D","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1136\/bjsports-2015-094948","article-title":"Does revision ACL reconstruction measure up to primary surgery? 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(evaluation of coronal lateral collateral ligament sign, tibial rotation, and translation measurements in postoperative MRI)","volume":"59","author":"Karatekin YS","year":"2023","journal-title":"Medicina"},{"issue":"4","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1177\/03635465211072562","article-title":"Double\u2010bundle versus single\u2010bundle anterior cruciate ligament reconstruction in patients with significant passive anterior tibial subluxation","volume":"50","author":"Lin L","year":"2022","journal-title":"Am J Sports Med"},{"issue":"10","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"2852","DOI":"10.1016\/j.arthro.2022.04.012","article-title":"Anterior tibial subluxation of lateral compartment is associated with high\u2010grade rotatory instability for acute but not chronic anterior cruciate ligament injuries: an magnetic resonance imaging case\u2010control study","volume":"38","author":"Liu 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anterior tibial subluxation in the setting of anterior cruciate ligament injuries: a comparative analysis of ligament\u2010deficient states","volume":"45","author":"McDonald LS","year":"2017","journal-title":"Am J Sports Med"},{"issue":"3","key":"e_1_2_13_19_1","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1002\/arj.70080","article-title":"Increased preoperative lateral anterior tibial subluxation by magnetic resonance imaging is associated with increased knee laxity after anatomical anterior cruciate ligament reconstruction","volume":"42","author":"Murakami R","year":"2026","journal-title":"Arthroscopy"},{"issue":"12","key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"2954","DOI":"10.1177\/0363546520949212","article-title":"Steep posterior tibial slope and excessive anterior tibial translation are predictive risk factors of primary anterior cruciate ligament reconstruction failure: a case\u2010control study with prospectively collected data","volume":"48","author":"Ni Q","year":"2020","journal-title":"Am J Sports Med"},{"issue":"1","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","DOI":"10.1177\/2309499019833606","article-title":"Analysis of anterior tibial subluxation to the femur at maximum extension in anterior cruciate ligament\u2010deficient knees","volume":"27","author":"Nishida K","year":"2019","journal-title":"J Orthop Surg"},{"issue":"5","key":"e_1_2_13_22_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671241246111","article-title":"Evaluation of anterior tibial translation under physiological axial load after ACL reconstruction with lateral extra\u2010articular tenodesis","volume":"12","author":"Pineda T","year":"2024","journal-title":"Orthop J Sports Med"},{"issue":"2","key":"e_1_2_13_23_1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/0363546519889628","article-title":"Posterior medial meniscus root tears potentiate the effect of increased tibial slope on anterior cruciate ligament graft forces","volume":"48","author":"Samuelsen BT","year":"2020","journal-title":"Am J Sports Med"},{"issue":"4","key":"e_1_2_13_24_1","doi-asserted-by":"crossref","first-page":"e219","DOI":"10.1111\/sms.12059","article-title":"Do pre\u2010operative knee laxity values influence post\u2010operative ones after anterior cruciate ligament reconstruction?","volume":"23","author":"Signorelli C","year":"2013","journal-title":"Scand J Med Sci Sports"},{"issue":"3","key":"e_1_2_13_25_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1177\/0363546519900158","article-title":"Excessive preoperative anterior tibial subluxation in extension is associated with inferior knee stability after anatomic anterior cruciate ligament reconstruction","volume":"48","author":"Song G","year":"2020","journal-title":"Am J Sports Med"},{"issue":"9","key":"e_1_2_13_26_1","doi-asserted-by":"crossref","first-page":"2396","DOI":"10.1177\/03635465211018859","article-title":"Increased posterior tibial 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Surg"},{"issue":"6","key":"e_1_2_13_29_1","doi-asserted-by":"crossref","first-page":"531","DOI":"10.2106\/JBJS.K.00733","article-title":"Outcome of revision anterior cruciate ligament reconstruction: a systematic review","volume":"94","author":"Wright RW","year":"2012","journal-title":"J Bone Jt Surg"},{"issue":"12","key":"e_1_2_13_30_1","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1016\/j.arthro.2023.04.010","article-title":"Combined anterior cruciate ligament and anterolateral ligament reconstruction decreases passive anterior tibial subluxation compared with isolated anterior cruciate ligament reconstruction despite similar rotational stability and clinical outcomes","volume":"39","author":"Yang HY","year":"2023","journal-title":"Arthroscopy"},{"issue":"7","key":"e_1_2_13_31_1","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.1177\/03635465231166712","article-title":"Association between anterior tibial subluxation of lateral compartment and high\u2010grade knee laxity in patients with anterior cruciate ligament deficiency","volume":"51","author":"Ye Z","year":"2023","journal-title":"Am J Sports Med"},{"issue":"9","key":"e_1_2_13_32_1","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.23.01137","article-title":"Identifying risk factors from preoperative MRI measurements for failure of primary ACL reconstruction: a nested case\u2010control study with 5\u2010year follow\u2010up","volume":"107","author":"Zhang Z","year":"2025","journal-title":"J Bone Jt Surg"},{"key":"e_1_2_13_33_1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.knee.2021.10.012","article-title":"Anterior and rotational tibial subluxation in the setting of anterior cruciate ligament injuries: an MRI analysis","volume":"33","author":"Zhang Z","year":"2021","journal-title":"Knee"}],"container-title":["Knee Surgery, Sports Traumatology, 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