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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article presents data from a study that was conducted to determine the relationship between lateral tibial posterior slope (LTPS) and the probability of early graft failure in patients who have undergone anterior cruciate ligament (ACL) reconstruction. The results showed that regardless of graft type, increased LTPS is associated with an increased risk for early ACL graft failure, especially in women.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EJoshua Christensen, MD, Mayo Clinic, Rochester, Minnesota, USA, presented data from a study that was conducted to determine the relationship between lateral tibial posterior slope (LTPS) and the probability of early graft failure in patients who have undergone anterior cruciate ligament (ACL) reconstruction. The results showed that regardless of graft type, increased LTPS is associated with an increased risk for early ACL graft failure, especially in women.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EA growing number of reports suggest that LTPS is a risk factor for ACL injury [Wordeman SC et al. \u003Cem\u003EAm J Sports Med\u003C\/em\u003E 2012]. However, the effect of LTPS on ACL graft failure is unknown. With this in mind, Dr. Christensen and colleagues conducted a case-control study in skeletally mature patients who experienced early graft failure following primary ACL reconstruction and underwent surgical revision between 1998 and 2009.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EExclusion criteria included clinical follow-up of \u0026lt; 4 years, graft failure occurring \u0026gt; 2 years from the time of the primary surgery, skeletal immaturity, deep infection, lack of availability of preoperative magnetic resonance imaging (MRI), and a history of previous proximal tibial trauma. Among 58 cases that were originally evaluated for inclusion, 35 cases (n = 21 for men) remained in which patients experienced early (within 2 years) failure of primary ACL reconstruction. These were matched to 35 control cases (n = 21 for men) involving patients who had undergone ACL reconstruction with a minimum of 4 years of clinical follow-up and no evidence of graft failure. Patients were matched by age, gender, date of primary surgery, and graft type (n = 14 for bone\u2014patellar tendon\u2014bone, n = 13 for hamstring autograft, and n = 8 for allograft in each group). Lateral tibial slope was determined on MRI imaging in blinded fashion.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EIn the graft failure group, all 35 cases failed within 2 years of primary ACL reconstruction, with a mean time to failure of 1 year (range, 0.6 to 1.4 years). In the matched control group, mean follow-up was 6.9 years (range, 4.0 to 13.9 years). Overall in the early ACL failure group, mean lateral tibial slope was significantly higher than that the control group (8.4\u00b0 vs 6.5\u00b0; p = .012; odds ratio [OR], 1.6; 95% CI, 1.1 to 2.2), and the ORs increased to 2.4 (95% CI, 1.2 to 5.0) and 3.8 (95% CI, 1.3 to 11.3) with 4\u00b0 and 6\u00b0 increases in tibial slope, respectively.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThis effect was also particularly pronounced in women, in which group mean lateral tibial slope was also significantly higher than in the control group (9.1\u00b0 vs 5.9\u00b0; p = .007; OR, 2.2; 95% CI, 1.0 to 5.2). The ORs increased to 4.9 (95% CI, .9 to 26.7) and 10.9 (95% CI, .9 to 26.7) with 4\u00b0 and 6\u00b0 increases in tibial slope, respectively.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThere was no significant association between graft type and primary ACL reconstruction failure.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ELimitations of this study included its retrospective nature, as well as the need for dedicated software and the multiple steps required for measurement. However, because the data show that increased LTPS is associated with an increased risk for early ACL graft failure, Dr. Christensen concluded that orthopedic surgeons should consider measuring LTPS as part of their preoperative assessment of patients with ACL injury.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/23\/12.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzowod\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}