Medial meniscal and bony slopes are higher in knees with failed ACL reconstruction than in patients with successful ACL reconstruction.

Background: We aimed to compare tibial soft tissue and bony slopes in patients with failed and non-failed ACL reconstructions (ACLR). We hypothesized that patients with failed ACLR have increased slopes compared to non-failed ACLR, and unexplained failures have higher slopes than failures with clear technical errors and failed synthetic ligaments.

Methods: Between 2015 and 2022, 130 patients with failed ACLR were retrospectively identified; 79 knees with adequate MRI scans were analyzed.