{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:56:30Z","timestamp":1783353390867,"version":"3.54.6"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:00:00Z","timestamp":1528070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:00:00Z","timestamp":1528070400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:00:00Z","timestamp":1528070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR 056630"],"award-info":[{"award-number":["R01 AR 056630"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR 056630"],"award-info":[{"award-number":["R01 AR 056630"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the correlation between posterior tibial slope (PTS) and tibial tunnel widening after anterior cruciate ligament reconstruction (ACL\u2010R).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010five patients underwent anatomic single\u2010bundle ACL\u2010R using quadriceps tendon autograft. Six months after surgery, each patient underwent high\u2010resolution computed tomography (CT). Tibial tunnel aperture location was evaluated using a grid method. Medial and lateral PTS (\u00b0) was measured based on a previously described method. To evaluate tibial tunnel widening, cross\u2010sectional area (CSA) of the tibial tunnel beneath the aperture was measured using CT axial slice. Nominal elliptical area was calculated using the diameter of a dilator during the surgery and the angle between the axial slice and the tunnel axis. Percentage of tunnel widening (%) was determined by dividing the CSA by the nominal area. Pearson correlation coefficient was used to explore the association between medial\/lateral PTS and tibial tunnel widening (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Location of tibial tunnel aperture was 29.8\u2009\u00b1\u20096.3% in anterior\u2013posterior direction, and 45.7\u2009\u00b1\u20092.1% in medial\u2013lateral direction. Medial and lateral PTS were 3.7\u00b0\u2009\u00b1\u20092.5\u00b0 and 4.9\u00b0\u2009\u00b1\u20092.4\u00b0 respectively. Tibial tunnel widening was 97.2\u2009\u00b1\u200920.3%. Tibial tunnel widening was correlated with medial PTS (<jats:italic>r<\/jats:italic>\u2009=\u20090.558, <jats:italic>P<\/jats:italic>\u2009=\u20090.004) and lateral PTS (<jats:italic>r<\/jats:italic>\u2009=\u20090.431, <jats:italic>P<\/jats:italic>\u2009=\u20090.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Steeper medial and lateral PTS correlated with greater tibial tunnel widening. The clinical relevance is that surgeons should be aware that PTS may affect tibial tunnel widening after ACL\u2010R. Thus, subjects with steeper PTS may need to be more carefully followed to see if there is greater tibial tunnel widening, which might be important especially in revision ACL\u2010R.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-018-5004-5","type":"journal-article","created":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:52:23Z","timestamp":1528073543000},"page":"3717-3723","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Steeper posterior tibial slope correlates with greater tibial tunnel widening after anterior cruciate ligament reconstruction"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8996-0299","authenticated-orcid":false,"given":"Kanto","family":"Nagai","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"},{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Kobe University Graduate School of Medicine Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Tashiro","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Herbst","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"},{"name":"<!--<label>3<\/label>--> Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar Technical University Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Gale","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Ho","family":"Wang","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Irrgang","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Anderst","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddie H.","family":"Fu","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery University of Pittsburgh Kaufmann Building Suite 1011, 3471 Fifth Avenue 15213 Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20104204\u20100"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514523721"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512466384"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515597664"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050138"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.76B5.8083263"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2001.21509"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503258880"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509349055"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2562-4"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050105"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010009\u20100711\u20103"},{"key":"e_1_2_8_14_2","first-page":"377","volume-title":"Current concepts in ACL reconstruction","author":"Irrgang JJ","year":"2008"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.04.003"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101455\u20107"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.00655"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050056"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.2011.23.4.227"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514521770"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1114\/1.1615572"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100952\u20104"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010015\u20102247\u20101"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2014.01.055"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103034\u20101"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310022101"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20104157\u20103"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506290059"},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.02.009"},{"key":"e_1_2_8_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010017\u20104435\u20108"},{"key":"e_1_2_8_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517741497"},{"key":"e_1_2_8_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.21242"},{"key":"e_1_2_8_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514563277"},{"key":"e_1_2_8_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.01.041"},{"key":"e_1_2_8_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101823\u20103"},{"key":"e_1_2_8_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513503288"},{"key":"e_1_2_8_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515570461"},{"key":"e_1_2_8_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513483271"},{"key":"e_1_2_8_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4611-x"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00167-018-5004-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-018-5004-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-018-5004-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-018-5004-5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T09:02:33Z","timestamp":1760864553000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-018-5004-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,4]]},"references-count":39,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1007\/s00167-018-5004-5"],"URL":"https:\/\/doi.org\/10.1007\/s00167-018-5004-5","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,4]]},"assertion":[{"value":"16 March 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare no conflicts of interest in association with the present study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This research was funded by NIH\/NIAMS, Grant No. R01 AR 056630.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The institutional review board (IRB) for human subject research in University of Pittsburgh approved all aspects of this study (ID: PRO09020493).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all patients before the enrollment.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}