ACL rupture from medial meniscus tear and high tibial slope: Case report

ABSTRACT Introduction and importance: Tears in the posterior medial meniscus leading to anterior cruciate ligament (ACL) rupture are rare. While the ACL is the primary structure responsible for anterior knee stability, its function can also be influenced by the medial meniscus and the posterior tibial slope. Case presentation: We report a case of a patient with a rupture of the posterior medial meniscus accompanied by a significantly elevated posterior tibial slope. Despite undergoing two arthroscopic meniscectomies, the patient failed to recover. Four years postoperatively, the anterior cruciate ligament degenerated and ruptured. Clinical discussion: We hypothesize that damage to the posterior medial meniscus may increase stress on the anterior cruciate ligament, particularly in the presence of a high posterior tibial slope. Conclusion: Early surgical repair improved outcomes in medial meniscal posterior horn tears. Tibial slope correction reduced revision rates in patients with >10°tibial slope undergoing ACL reconstruction. Highlights