The increased lateral tibial slope may result in inferior long-term clinical outcome after DB-ACL reconstruction

Purpose To determine if there is a correlation between lateral tibial slope and long-term clinical results in patients who underwent double-bundle ACL reconstruction.Methods We retrospectively reviewed patients that received double-bundle ACL reconstruction at a single institution by a single surgeon from January 2011 to December 2014. All the magnetic resonance imaging were reviewed and lateral tibial slopes (LTS) were recorded by an experienced surgeon and rechecked by the other two authors of this study that specialized in orthopedic knee surgery. The relationship between PROMs measurement and lateral tibial slope were analyzed. The patients were then separated into two groups (LTS > 7.4 degrees and < 7.4 degrees) according to the previous study.Results A total of 119 patients were enrolled in this study. All enrolled patients were followed for at least 8 years. The PROMS result were negatively correlated with the lateral tibial slope (p values all < 0.001). The patients with high lateral tibial slope had significantly lower PROMS values (Lysholm 94.26 +/- 5.61 vs 80.15 +/- 8.28, p = 0.013; IKDC 82.99 +/- 4.55 vs 70.09 +/- 7.15, p = 0.003; Tegner 9.32 +/- 0.95 vs 6.85 +/- 1.99, p < 0.001). Finally, the LTS cutoff value between patients with "Good" and "Fair" Lysholm score in our study was 7.55 degrees.Conclusions Patients with high lateral tibial slope may result in inferior long-term subjective outcomes. The using of double-bundle ACL reconstruction along cannot overcome the negative impact caused by steep lateral tibial slope. A lateral tibial slope of 7.55 degrees may be used as a cut-off for a good clinical outcome.Level of evidence III retrospective comparative prognostic trial.