Coronal subluxation of the tibiofemoral joint before and after anterior cruciate ligament reconstruction

Abstract Background Studies have shown that medial subluxation of the tibia occurs after anterior cruciate ligament (ACL) rupture. However, it is unclear whether anterior cruciate ligament reconstruction (ACLR) can correct tibial coronal subluxation. Purpose To determine whether the tibia is medially subluxated after ACL rupture, and whether ACLR can correct medial subluxation of the tibia. Study design Case series; Level of evidence, 4, Retrospective clinical study. Methods The distance of tibial coronal subluxation before and after ACLR surgery was measured in 48 patients with ACL rupture and meniscus injury. Tibiofemoral subluxation was defined as the perpendicular distance between the long axis of the tibia and a second parallel line originating at the most proximal aspect of the femoral intercondylar notch. To determine the long axis of the tibia, two circles separated by 5 cm were centered on the proximal tibia. The proximal circle is 5 cm from the tibial plateau, and the distal circle is 5 cm from the proximal circle. The line passing through the center of the two circles was considered the long axis of the proximal tibia. Care was taken to ensure that each patient lied on the back with their patellae facing upward, to minimize rotational variation among the radiographs. At the same time, 30 patients with simple meniscus injury who underwent arthroscopy during the same period were selected to determine the degree of tibiofemoral coronal subluxation as the baseline value. The changes before and after operation were compared, as well as the differences with the baseline data. Result The average follow-up period was 21.2 ± 5.8 months. The average distance of tibial coronal subluxation before ACLR was 5.5 ± 2.1 mm, which was significantly different from that of baseline group (7.3 ± 2.1 mm) (P