JHSM
Journal of Health Sciences and Medicine

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Original Article
Association between posterior tibial slope and sagittal anteroposterior position of the tibial tunnel after primary anterior cruciate ligament reconstruction
Abstract
Aims: In anterior cruciate ligament (ACL) reconstruction, sagittal tibial tunnel placement is an important determinant of surgical success. Posterior tibial slope (PTS) may influence anterior tibial translation and graft-loading. This study evaluated the relationship between the PTS and sagittal tibial tunnel position (AP%) after isolated primary ACL reconstruction. Methods: Eighty-seven patients were retrospectively reviewed in this study. On postoperative true lateral radiographs, PTS and tibial tunnel AP (%) were measured and normalized to the tibial plateau length: AP (%)=(tunnel distance/plateau A-P length)×100. True lateral quality was assessed using the posterior condylar superposition offset (PCSO), and radiographs with PCSO >5 mm were excluded. Reliability was assessed using the intraclass correlation coefficients (ICC). The association between PTS and AP (%) was tested using Spearman’s correlation and multiple linear regression [AP (%) dependent; PTS and PCSO predictors]. Results: The mean PTS was 13.70±3.05° (7.85-20.16). The sagittal anteroposterior length of the tibial plateau was 43.85±3.89 mm (35.57-54.45 mm), and the sagittal distance from the anterior edge to the center of the tibial tunnel was 12.82±3.58 mm (6.64-21.40 mm). The mean AP (%) was 29.23±7.76 (16.40-46.42). The measurement reliability was high for both PTS and AP (%). A moderate, statistically significant negative correlation was found between the PTS and AP (%) (?=-0.431; p

Keywords : Anterior cruciate ligament reconstruction, posterior tibial slope, tibial tunnel, sagittal alignment

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Article available in :
Volume 9, Issue 4, 2026
Page : 917-921
https://doi.org/10.32322/jhsm.1911317
Article Information
Received : 17 Mar 2026
Accepted : 25 May 2026
Published : 20 Tem 2026
Corresponding Author :

Yüksel Uğur Yaradılmış: Department of Orthopedics and Traumatology, Adana City Hospital, Adana, Turkiye

[email protected]
Citation : Polat Y, Yaradılmış YU. Association between posterior tibial slope and sagittal anteroposterior position of the tibial tunnel after primary anterior cruciate ligament reconstruction. J Health Sci Med. 2026;9(4):917-921. doi:10.32322/jhsm.1911317

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