{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:15:17Z","timestamp":1791443717770,"version":"4.3.3"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine the prevalence of an \u201cincreased posterior tibial slope (PTS)\u201d (PTS\u2009\u2265\u200912\u00b0) in a population with one, two or\u2009\u2265\u2009three anterior cruciate ligament (ACL) graft insufficiencies. Furthermore, to investigate whether the prevalence of an increased PTS and the absolute PTS increases with an increasing number of ACL graft insufficiencies, as well as to determine the survival time of the first ACL graft.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients diagnosed with an ACL graft insufficiency between January 2021 and March 2022 were included. The PTS was measured using the proximal anatomical tibial axis on long lateral knee radiographs. Patients were divided into 3\u00a0groups depending on the number of ACL graft insufficiencies: group A (1\u00a0graft insufficiency), group B (2\u00a0graft insufficiencies) and group C (\u2265\u20093\u00a0graft insufficiencies). The prevalence of increased PTS and absolute PTS between groups was compared alongside the survival of the first ACL graft between patients with or without increased PTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two\u2010hundred and six patients (147\u00a0males\/59 females) met the inclusion criteria. 73 patients showed an increased PTS [prevalence 35% [95% confidence interval (CI) (29%; 42%)]. 155 patients were found in category A, 42 patients in B and 9 patients in C. The prevalence of increased PTS for group A, B and C was, 32% [95% CI (25%; 40%)], 38% [95% CI (23%; 53%)] and 78% [95% CI (51%; 100%)], respectively. The prevalence of increased PTS and mean PTS did not increase significantly between group A and B. However, both parameters increased significantly between group A and C, and group B and C (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The survival time of the first ACL graft in patients with or without an increased PTS was 3 (interquartile range (IQR) 5) and 6 years (IQR 9), respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a 35% prevalence of increased PTS in the studied ACL graft insufficient patient cohort. The survival of the first ACL graft is shorter in patients with an increased PTS. Surgeons should be aware of the high prevalence of increased PTS when consulting patients for revision ACL reconstruction as it is an important risk factor for recurrent instability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>3.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07313-2","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T11:11:23Z","timestamp":1673262683000},"page":"2974-2982","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["High prevalence of increased posterior tibial slope in ACL revision surgery demands a patient\u2010specific approach"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4755-154X","authenticated-orcid":false,"given":"Wouter","family":"Beel","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Centre for Sports Orthopedics and Special Joint Surgery Orthopedic Hospital Markgroeningen Kurt\u2010Lindemann\u2010Weg 10 71706 Markgroeningen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Schuster","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre for Sports Orthopedics and Special Joint Surgery Orthopedic Hospital Markgroeningen Kurt\u2010Lindemann\u2010Weg 10 71706 Markgroeningen Germany"},{"name":"<!--<label>2<\/label>--> Paracelsus Medical University Nuremberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Michalski","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre for Sports Orthopedics and Special Joint Surgery Orthopedic Hospital Markgroeningen Kurt\u2010Lindemann\u2010Weg 10 71706 Markgroeningen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Mayer","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre for Sports Orthopedics and Special Joint Surgery Orthopedic Hospital Markgroeningen Kurt\u2010Lindemann\u2010Weg 10 71706 Markgroeningen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schlumberger","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre for Sports Orthopedics and Special Joint Surgery Orthopedic Hospital Markgroeningen Kurt\u2010Lindemann\u2010Weg 10 71706 Markgroeningen Germany"},{"name":"<!--<label>3<\/label>--> Department of Orthopedics and Traumatology Medical University of Innsbruck Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotta","family":"Hielscher","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre for Sports Orthopedics and Special Joint Surgery Orthopedic Hospital Markgroeningen Kurt\u2010Lindemann\u2010Weg 10 71706 Markgroeningen Germany"},{"name":"<!--<label>4<\/label>--> Paracelsus Medical University Salzburg Austria"},{"name":"<!--<label>5<\/label>--> Department of Orthopedics Medical University Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Richter","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Centre for Sports Orthopedics and Special Joint Surgery Orthopedic Hospital Markgroeningen Kurt\u2010Lindemann\u2010Weg 10 71706 Markgroeningen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,9]]},"reference":[{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517741497"},{"key":"e_1_2_12_3_2","doi-asserted-by":"crossref","unstructured":"BattyLM FirthA MoatsheGet al. 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