ACL Reconstruction & Posterior Tibial Slope

The anterior cruciate ligament (ACL) is essential for knee stability during pivoting sports. ## When is surgery needed? ACL reconstruction is recommended for active patients with instability, especially athletes who wish to return to pivoting sports. ## Graft options Hamstring autograft and bone-patellar tendon-bone (BPTB) autograft are the most common. Each has advantages — we discuss the best option for your activity level. ## Posterior tibial slope (PTS) Research by Dr. Ali Fares at CHU Grenoble Alpes showed that a PTS ≥ 10° is associated with 5.7× higher risk of further ACL injury after reconstruction. Identifying this risk factor helps tailor surgical planning and rehabilitation. ## Recovery timeline Most patients begin physiotherapy within days. Return to sport typically takes 6–9 months with structured testing.