Steeper Tibial Slope, LET Use Linked to ACL Revision Risk

A multicenter cohort study of 780 patients aged 25 or younger undergoing primary ACL reconstruction examined posterior tibial slope (PTS) and use of lateral extra-articular tenodesis (LET) in relation to revision surgery. The study reported that increased PTS (≥12°) was present in 28.2% of patients and was independently associated with higher odds of revision, while LET was independently associated with substantially lower odds of revision regardless of PTS. In patients with PTSmax ≥12°, the study reported revision rates of 21.0% without LET versus 9.2% with LET.

Most relevant for: Young, high-risk patients undergoing primary ACL reconstruction, particularly those with increased posterior tibial slope.

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