Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleThe Association Between Posterior-Inferior Tibial Slope and Anterior Cruciate Ligament Insufficiency
Section snippets
Methods
Our patient group consisted of 100 patients (66 male and 34 female patients) who were diagnosed with ACL insufficiency and examined in our practices between 1998 and 2003. The patients’ histories, physical examinations, and magnetic resonance imaging findings were used to confirm the diagnosis and ensure that no other ligamentous compromise or capsular injury occurred and that the ACL injury was via a noncontact mechanism. The 4 senior authors (M.F.S., G.R.B., M.I.F., and J.R.B.) conducted all
Results
The negative control group of 100 patients with patellofemoral pain had a mean PITS of 8.5° ± 3.0°, with a mean PITS of 8.6° ± 2.7° in the female group (n = 51) and 8.4° ± 3.4° in the male group (n = 49). The case group of 100 ACL-insufficient patients had a mean PITS of 11.2° ± 3.8°, with a mean PITS of 12.0° ± 3.5° in the female group (n = 34) and 10.8° ± 3.9° in the male group (n = 66). ANOVA determined that the mean PITS of the ACL-insufficient case group was significantly greater than that
Discussion
Prior studies have concluded that shearing forces exist that act across the tibiofemoral joint during stance. Shoemaker and Markolf17 proved in a cadaveric model that anterior tibial translation could occur with axial loading alone when the ACL and the medial meniscus have been transected. Dejour and Bonnin2 conducted a prospective case-control study that showed that there was 6 mm of increased anterior tibial translation for every 10° of increased PITS when patients were placed in the lateral,
Conclusions
The results of our study suggest that an increased degree of PITS is indeed associated with noncontact ACL rupture in both male and female patients. We demonstrated no significant difference in the mean PITS between men and women in our ACL-insufficient case group. Increased PITS is associated with increased pivot-shift grades on examination with patients under anesthesia.
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The authors report no conflict of interest.