2023 ISAKOS Biennial Congress ePoster
Elevated Tibial Spine Height as a Predictor of Reinjury after Anterior Cruciate Ligament Reconstruction
Naofumi Hashiguchi, MD,MPH, Hiroshima JAPAN
Atsuo Nakamae, MD, PhD, Hiroshima JAPAN
Goki Kamei, MD, PhD, Hiroshima JAPAN
Masakazu Ishikawa, MD, PhD, Kita-Gun, Kagawa JAPAN
Nobuo Adachi, MD, PhD, Hiroshima JAPAN
Hiroshima University Hospital, Hiroshima city, JAPAN
FDA Status Cleared
Summary
The difference in tibial spine height (medial/lateral) between at 1 year postoperatively and at the first preoperative MRI was larger in patients with reinjury of ACL than in those without reinjury, which may be a predictive factor for reinjury.
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Abstract
Purpose
Reinjury after anterior cruciate ligament (ACL) reconstruction is a complication that should be avoided. However, the risk factors for reinjury on imaging evaluation are not well understood. In this study, we hypothesized that tibial spine height may be a predictor of reinjury after reconstruction.
Methods
This was a case control study within a single center. 603 patients underwent ACL reconstruction between January 2010 and December 2019 at our institution. Among them, 532 cases with evaluable MRI images stored in the electronic medical record and by only sports injuries without concomitant PCL reconstruction were included. The reinjury group (case group) consisted of 16 cases (8 females/8 males, mean age 19.1±5.8 years, mean BMI 23.5±4.7). The control group consisted of 67 patients (34 female/33 male, mean age 20.6±8.1 years, mean BMI 23.3±3.9). The following items were examined: duration between injury and surgery, Tegner score before and after surgery, graft size and meniscus repair. MRI was evaluated in medial/lateral posterior tibial slope, medial/lateral tibial spine height, tibial spine width, notch outlet length, the notch wide index measured from the distance between the inner and outer posterior femoral condyles at first-time preoperation. Medial/lateral tibial spine height and tibial spine width were also measured by MRI at 1 year postoperatively. Chi-square, Mann-Whitney tests were performed and Multiple regression analysis was performed for those that showed significant differences. The statistical software used was GraphPad Prism 9, and the significance level for all tests was set at p=0.05.
Results
Lateral posterior tibial slope was 8.2±3.6 ° in the case group and 11.0±3.6 ° in the control group, showing a significant difference (p<0.01). The difference in tibial spine height (medial/lateral) between MRI at 1 year after surgery and before the first surgery was 1.47±1.23/0.59±0.80mm in the case group and -0.18±0.92/-0.12±0.90mm in the control group, a significant difference (p<0.001 ). Multiple regression analysis was performed with the presence or absence of reinjury as the objective variable for the above three explanatory variables, and both the differences in tibial spine height (medial/lateral) were found to be significantly different (p<0.05).
Conclusion
The difference in tibial spine height (medial/lateral) between at 1 year postoperatively and at the first preoperative MRI was larger in patients with reinjury of ACL than in those without reinjury, which may be a predictive factor for reinjury.