Summary

The present study demonstrated that patellar tendon orientation was associated with ACL rupture and the Insall-Salvati ratio. To the best of our knowledge, it has been shown for the first time in the literature that patellar tendon orientation is associated with ACL rupture.

Abstract

The Effect of Relationship between Posterior Tibial Slope and Patellar Tendon Orientation on Anterior Cruciate Ligament Rupture

Aim

Anterior cruciate ligament (ACL) injury is one of the most common knee injuries. The aim of this study was to investigate the relationship between posterior tibial slope (PTS) and patellar tendon orientation (PTO) and ACL rupture.

Methods

Patients who were operated on due to ACL rupture at the Necmettin Erbakan University Meram Medical Faculty Department of Orthopedics and Traumatology clinic between 2015 and 2021 were analyzed retrospectively. A total of 160 people were included in this study in two groups: 80 patients with isolated ACL rupture and a control group of 80 patients with a similar distribution in terms of age and gender and normal knee appearance on MRI. Insall-Salvati ratio was calculated by dividing PTE measurements, patellar tendon length, and patella length. Additionally, the tibial slope-patellar tendon angle (TSPTA) was calculated between the line passing through the patellar tendon trace and the line tangent to the tibial plateaus.

Results

In the ACL rupture group, 47 (58.7%) were male and 33 (41.3%) were female. In the control group, 44 (55%) of the patients were male and 36 (45%) were female. PTE values of patients with ACL rupture were found to be significantly higher than the control group (p = 0.005). The mean Insall-Salvati ratio of the ACL rupture group was found to be significantly lower than the control group (p꞊0.043). When the TSPTA measurements of the patients before and after reconstruction were compared, the TSPTA value after reconstruction was found to be significantly higher than the TSPTA measurements made before reconstruction (p<0.001). When the TSPTA values of the patients who underwent reconstruction were compared with the TSPTA values of the control group, the TSPTA values of the patients who underwent reconstruction were found to be significantly higher (p<0.001).

Conclusion

The present study demonstrated that patellar tendon orientation was associated with ACL rupture and the Insall-Salvati ratio. To the best of our knowledge, it has been shown for the first time in the literature that patellar tendon orientation is associated with ACL rupture. In order to reproduce and confirm the results of this study, further higher clinical evidence studies are warranted.