Ipsilateral ACL injured patients with Segond fractures demonstrate increased posterior tibial slope.


Journal

The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798

Informations de publication

Date de publication:
Oct 2022
Historique:
received: 22 12 2021
revised: 26 03 2022
accepted: 15 07 2022
pubmed: 6 8 2022
medline: 14 10 2022
entrez: 5 8 2022
Statut: ppublish

Résumé

The anterolateral complex has been demonstrated to assist with rotational stability and prevention of anterior tibial translation during the pivot shift. In this study the Segond fracture is used as a surrogate for an anterolateral complex injury to determine if there is an association between Segond fracture and increased posterior tibial slope. Patients' charts and radiographs were analyzed retrospectively for the presence of Segond fractures on injury radiographs. These patients, the Segond cohort, were then age and gender matched to a control cohort. Demographic as well MRI measurements of medial and lateral posterior tibial slope and lateral-to-medial slope asymmetry were collected for each cohort. Secondary outcome of anterior cruciate ligament reconstruction failure data was also collected. The Segond group demonstrated a statistically significantly greater lateral posterior tibial slope (8.42° versus 6.55°, P = 0.003) as well as medial posterior tibial slope (6.57° versus 5.34° degrees, P = 0.045). There was no significant differences between lateral-to-medial asymmetry (2.18°versus 1.83°, P = 0.246). Patients with Segond fractures at the time of anterior cruciate ligament injury have increased medial and lateral posterior tibial slope. This may relate to increased rotational and translational instability associated with anterolateral complex injuries. Surgeons treating these patient may use this information to counsel their patients on the risks of associated pathology at the time of arthroscopy such as lateral meniscal posterior root tears.

Sections du résumé

BACKGROUND BACKGROUND
The anterolateral complex has been demonstrated to assist with rotational stability and prevention of anterior tibial translation during the pivot shift. In this study the Segond fracture is used as a surrogate for an anterolateral complex injury to determine if there is an association between Segond fracture and increased posterior tibial slope.
METHODS METHODS
Patients' charts and radiographs were analyzed retrospectively for the presence of Segond fractures on injury radiographs. These patients, the Segond cohort, were then age and gender matched to a control cohort. Demographic as well MRI measurements of medial and lateral posterior tibial slope and lateral-to-medial slope asymmetry were collected for each cohort. Secondary outcome of anterior cruciate ligament reconstruction failure data was also collected.
RESULTS RESULTS
The Segond group demonstrated a statistically significantly greater lateral posterior tibial slope (8.42° versus 6.55°, P = 0.003) as well as medial posterior tibial slope (6.57° versus 5.34° degrees, P = 0.045). There was no significant differences between lateral-to-medial asymmetry (2.18°versus 1.83°, P = 0.246).
CONCLUSION CONCLUSIONS
Patients with Segond fractures at the time of anterior cruciate ligament injury have increased medial and lateral posterior tibial slope. This may relate to increased rotational and translational instability associated with anterolateral complex injuries. Surgeons treating these patient may use this information to counsel their patients on the risks of associated pathology at the time of arthroscopy such as lateral meniscal posterior root tears.

Identifiants

pubmed: 35930896
pii: S0968-0160(22)00109-0
doi: 10.1016/j.knee.2022.07.009
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

76-81

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Lucas Haase (L)

University Hospitals Cleveland Medical Center, Cleveland, OH, USA. Electronic address: lucas.haase@uhhospitals.org.

Steven Magister (S)

University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Grant Nelson (G)

University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Yazdan Raji (Y)

University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Jacob Calcei (J)

University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

James Voos (J)

University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Michael Karns (M)

University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

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