Posterior Tibial Offset Ratio (PTOR) Is Associated With Revision After Hamstring-Autograft Anterior Cruciate Ligament Reconstruction: A Matched Case-Control Study

Background

Graft failure after primary anterior cruciate ligament (ACL) reconstruction remains clinically important. This study evaluated the posterior tibial offset ratio (PTOR), defined as posterior plateau distance (PPD) divided by anterior plateau distance (APD) on a true lateral radiograph, as a complementary descriptor of sagittal tibial plateau morphology and compared it with posterior tibial slope (PTS). Hypothesis: Higher PTOR would be associated with revision after hamstring-autograft ACL reconstruction and this association would persist after accounting for PTS and total plateau length. Study Design: Case-control study; Level of evidence, 3.