{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T07:59:51Z","timestamp":1780819191144,"version":"3.54.1"},"reference-count":36,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Slope-reducing high tibial osteotomy (SRO-HTO) surgically corrects elevated posterior tibial slope (PTS) and is often performed in the setting of failed anterior cruciate ligament (ACL) reconstruction. Lateral supratubercle angle (LSTA) quantifies the supratubercle component of elevated PTS, but the infratubercle component of elevated PTS has not been quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis\/Purpose:<\/jats:title>\n                    <jats:p>The purpose of this study was to describe and establish mean values for lateral infratubercle angle (LITA) within non-ACL tear, primary ACL tear, and ACL graft tear cohorts. It was hypothesized that LITA would differ between non-ACL tear and ACL graft tear cohorts, would positively correlate with PTS elevation, and, when used with LSTA, would localize the deformity leading to PTS elevation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients seen for a knee complaint were categorized into non-ACL tear, primary ACL tear, or ACL graft tear cohorts. PTS, LSTA, and LITA were measured on full-length lateral (FLL) tibia radiographs. Descriptive statistics were calculated for each measurement and cohort, and comparisons were performed using a 1-way analysis of variance with a Bonferroni correction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01 indicating statistical significance). The non-ACL tear cohort's mean LITA value served as the cutoff. Pearson's correlation determined the relationship between elevated PTS with LITA and LSTA.\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05 indicated statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 300 patients were included, 100 per cohort. The mean LITA in the non-ACL tear, primary ACL tear, and ACL graft tear cohorts were 89\u00b0\u00b1 4.6\u00b0, 90.7\u00b0\u00b1 5.8\u00b0, and 92\u00b0\u00b1 5\u00b0, respectively. Significant differences existed in LITA between the non-ACL tear and ACL graft tear cohorts (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Within the ACL graft tear cohort, 74.4% (64\/86) of patients with elevated medial or lateral PTS (PTS-M\/L) had elevated LITA, regardless of LSTA elevation status. Significant positive correlations existed between PTS-M\/L and LITA in the non-ACL tear (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .011\/\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004), primary ACL tear (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002\/\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .029), and ACL graft tear cohorts (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001\/\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001\/\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>LITA is a novel measurement, with distinct anatomic landmarks, that quantifies infratubercle deformity and can be easily incorporated into FLL radiographic assessment. Elevated LITA was present in most patients with elevated PTS in both the primary ACL tear and ACL graft tear cohorts, indicating a contribution from infratubercle deformity. We recommend utilizing LITA and LSTA with PTS to quantify region-specific proximal sagittal deformity. Future studies should determine whether this quantification can help surgeons select the SRO-HTO technique and influence outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671261445953","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T10:14:36Z","timestamp":1780654476000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Assessment of Infratubercle Sagittal Proximal Tibial Morphology and Relationship to Full Length Posterior Tibial Slope: Lateral Infratubercle Angle"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5073-246X","authenticated-orcid":false,"suffix":"III","given":"Alfred","family":"Mansour","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Texas Health Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Dziuba","family":"Waters","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Texas Health Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4600-6849","authenticated-orcid":false,"given":"Nicole","family":"Lemaster","sequence":"additional","affiliation":[{"name":"Memorial Hermann Rockets Sports Medicine Institute, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kutzler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Texas Health Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connor","family":"Fritz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Texas Health Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Lowe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Texas Health Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4428-487X","authenticated-orcid":false,"given":"Alexis","family":"Aboulafia","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Texas Health Center, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3403-9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518820302"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-022-03419-4"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515597664"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.09.006"},{"key":"e_1_3_2_7_2","first-page":"28","article-title":"Osteotomie tibiale de d\u00e9flexion et laxit\u00e9 chronique ant\u00e9rieure \u00e0 propos de 22 cas","volume":"84","author":"Dejour D","year":"1998","unstructured":"Dejour D, Dejour H. Osteotomie tibiale de d\u00e9flexion et laxit\u00e9 chronique ant\u00e9rieure \u00e0 propos de 22 cas. Rev Chir Orthop Reparatrice Appar Mot. 1998;84:28-28.","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3758-6"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2023.08.007"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2019.01.001"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-2864-1"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503258880"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2018.07.003"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05360-2"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06888-6"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465251331005"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671241241346"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00259"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2022.03.032"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1060-1872(00)80027-1"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520949212"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2024.103153"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13164715"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(20)31927-1"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2019.05.026"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517741497"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002864"},{"issue":"9","key":"e_1_3_2_29_2","article-title":"Anterior closing wedge osteotomy for failed anterior cruciate ligament reconstruction: state of the art","volume":"6","author":"Shekhar A","year":"2022","unstructured":"Shekhar A, Tapasvi S, van Heerwaarden R. Anterior closing wedge osteotomy for failed anterior cruciate ligament reconstruction: state of the art. J Am Acad Orthop Surg Glob Res Rev. 2022;6(9):e22.","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.21242"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520963083"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B11.26905"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514534938"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117697287"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.10.048"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-021-09729-0"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513503288"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671261445953","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259671261445953","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671261445953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T07:46:39Z","timestamp":1780818399000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259671261445953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/23259671261445953"],"URL":"https:\/\/doi.org\/10.1177\/23259671261445953","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"article-number":"23259671261445953"}}