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The main objective was to determine whether increased bone loss of the posterolateral tibial plateau is associated with residual rotational instability and impaired functional outcome after ACL reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort was identified in a prospective enrolled study of patients suffering acute ACL injury who underwent preoperative standard radiographic diagnostics and clinical evaluation. Patients were included when scheduled for isolated single\u2010bundle hamstring autograft ACL reconstruction. Exclusion criteria were concurrent anterolateral complex (ALC) reconstruction (anterolateral tenodesis), previous surgery or symptoms in the affected knee, partial ACL tear, multi\u2010ligament injury with an indication for additional surgical intervention, and extensive cartilage wear. On MRI, bony (TPIF, tibial plateau, and femoral condyle morphology) and ligament status (ALC, concomitant collateral ligament, and meniscus injuries) were assessed by a musculoskeletal radiologist. Clinical evaluation consisted of KT\u20101000, pivot\u2010shift, and Lachman testing, as well as Tegner activity and IKDC scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010eight patients were included with a minimum follow\u2010up of 12\u00a0months. TPIF was identified in 85% of ACL injuries (<jats:italic>n<\/jats:italic>\u2009=\u200949). The ALC was found to be injured in 31 of 58 (53.4%) cases. Pearson analysis showed a positive correlation between TPIF and the degree of concomitant ALC injury (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Multiple regression analysis revealed an increased association of high\u2010grade TPIF with increased lateral tibial convexity (<jats:italic>p<\/jats:italic>\u2009=\u20090.010). The high\u2010grade TPIF group showed worse postoperative Tegner scores 12\u00a0months postoperatively (<jats:italic>p<\/jats:italic>\u2009=\u20090.035).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Higher degrees of TPIFs are suggestive of a combined ACL\/ALC injury. Moreover, patients with increased posterolateral tibial plateau bone loss showed lower Tegner activity scores 12\u00a0months after ACL reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07282-y","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T14:02:41Z","timestamp":1671199361000},"page":"2266-2273","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Extent of posterolateral tibial plateau impaction fracture correlates with anterolateral complex injury and has an impact on functional outcome after ACL reconstruction"],"prefix":"10.1002","volume":"31","author":[{"given":"Andreas","family":"Flury","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Department, Balgrist University Hospital University of Zurich Forchstrasse 340 8008 Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Hodel","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Department, Balgrist University Hospital University of Zurich Forchstrasse 340 8008 Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavian","family":"Andronic","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Department, Balgrist University Hospital University of Zurich Forchstrasse 340 8008 Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Kaiser","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Department, Balgrist University Hospital University of Zurich Forchstrasse 340 8008 Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Fritz","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Radiology, Balgrist University Hospital University of Zurich Forchstrasse 340 8008 Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2159-2071","authenticated-orcid":false,"given":"Florian B.","family":"Imhoff","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Department, Balgrist University Hospital University of Zurich Forchstrasse 340 8008 Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro F.","family":"Fucentese","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Department, Balgrist University Hospital University of Zurich Forchstrasse 340 8008 Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519893709"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520932912"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2006.04.098"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.01.040"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.05.039"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/emermed\u20102011\u2010200356"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520935866"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20104993\u20104"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00132\u2010018\u201003663\u20109"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010018\u20104949\u20108"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010198003000\u201000008"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518823544"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519858612"},{"key":"e_1_2_8_15_2","unstructured":"HodelS PostolkaB FluryA SchutzP TaylorWR VlachopoulosLet al. 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