Age under 20 years, pre-operative participation in pivoting sports, and steep posterior tibial slope of more than 12° are risk factors for graft failure after double-bundle anterior cruciate ligament reconstruction.

Purpose: Younger age and steep posterior tibial slope (PTS) have been reported as risk factors for graft failure after anterior cruciate ligament reconstruction (ACLR). Few studies have evaluated these risk factors simultaneously in a large cohort of patients undergoing double-bundle ACLR (DB-ACLR). Therefore, this retrospective study aimed to simultaneously investigate known risk factors such as PTS and age in DB-ACLR, determine their thresholds and calculate odds ratios (ORs).