KSSTA - 2026-08-03 - Journal Article
Association between tibiofemoral bone and meniscus morphology and dynamic tibiofemoral movements during jump-landing tasks in patients following ACL reconstruction.
Vendrig T, Brouwer RW, Hoogeslag RAG, Houdijk H, Olde Heuvel J, de Vries AJ, Keizer MNJ
Topics
Key Takeaway
In ACL-reconstructed knees, steeper lateral posterior tibial slope correlates with greater internal tibial rotation during jump-landing (peak r = 0.75), but only in the subgroup with a flat medial tibial plateau (n=13), limiting the generalizability of slope-reducing osteotomy as an adjunct procedure.
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Summary
This study examined whether pre-operative MRI-derived tibiofemoral bone and meniscus morphology predicted dynamic anterior tibial translation (ATTd) and internal tibial rotation (ITRd) during single-leg hop for distance and side hop tasks measured with 3D optoelectronic motion capture in 30 patients post-ACLR. Steeper lateral posterior tibial slope and greater medial-lateral slope difference correlated with less ATTd and greater ITRd (peak r = ±0.75), but only in the flat medial plateau subgroup (n=13). Greater lateral femoral condyle ratio independently predicted greater ITRd during both tasks (peak r up to 0.56, p=0.006), and smaller lateral meniscal posterior horn slope predicted greater ITRd during single-leg hop (peak r = -0.46).
Key Limitation
The critical slope-ITRd associations were derived from a subgroup of only 13 patients, making these correlations statistically fragile and insufficient to guide surgical decision-making.
Original Abstract
PURPOSE
To investigate whether tibiofemoral bone and meniscus morphology were associated with dynamic anterior tibial translation (ATTd) and internal tibial rotation (ITRd) during jump-landing tasks in anterior cruciate ligament (ACL)-reconstructed knees. Results may provide some guidance on the use of additional surgical procedures alongside (revision) ACL reconstruction (ACLR).
METHODS
Patients who underwent primary ACLR were included. Morphological features were measured using pre-surgery magnetic resonance images of the operated knee. Dependent variables included ATTd and ITRd during the landing of the single-leg hop for distance (SLHD) and side hop (SH), measured with three-dimensional optoelectronic motion capture. Univariate statistical parametric mapping regression analyses were conducted with morphological features as predictors.
RESULTS
Thirty patients were included at 4.7 ± 1.8 years post-ACLR (age: 31.0 ± 4.8 years). Steeper sagittal-plane lateral posterior tibial slope and greater medial-lateral difference in posterior tibial slope were significantly associated with less ATTd (peak r = -0.75; p = 0.048) and greater ITRd (peak r = 0.75; p = 0.047) during the SLHD and SH, but only in ACL-reconstructed knees with a flat medial tibial plateau (-2° to +2°; n = 13 subgroup analysis). Steeper coronal-plane tibial slope was significantly associated with less ATTd during the SLHD (peak r = -0.45; p = 0.049), and with greater ITRd during the SH (peak r = 0.47; p = 0.047). Smaller lateral meniscal slope of the posterior horn was significantly associated with greater ITRd during the SLHD (peak r = -0.46; p = 0.047). Greater lateral femoral condyle ratio was significantly associated with greater ITRd during the SLHD (peak r = 0.46; p = 0.04) and SH (peak r = 0.56; p = 0.006).
CONCLUSIONS
The observed associations with greater ITRd warrant further investigation into the potential role of anterolateral corner reconstruction alongside (revision) ACLR in patients with these morphological features. Since associations between posterior tibial slopes and ITRd depended on a flat medial plateau, the role of slope-reducing tibial osteotomy appears limited, as these procedures typically do not selectively target a single plateau.
LEVEL OF EVIDENCE
Level II.