Abstract
BACKGROUND: Posterior cruciate ligament (PCL) injury is common in sports, with anatomical factors like posterior tibial slope (PTS) and femoral intercondylar notch morphology potentially influencing risk. However, evidence remains limited and inconsistent. In addition to the PTS and femoral intercondylar angle, this study also investigated the potential roles of the lateral proximal tibial angle and lateral distal femoral angle in posterior cruciate ligament injuries. METHODS: A retrospective study was conducted including 169 participants: 80 with isolated PCL injuries and 89 controls. Anatomical parameters (PTS, femoral intercondylar angle, etc.) were measured from imaging. Univariate and multivariate analyses were used to evaluate associations with PCL injury. RESULTS: No significant differences in demographic variables. The PTS was significantly lower in the PCL group (7.81° ± 3.59°) than controls (11.06° ± 4.07°, P < 0.001). The femoral intercondylar angle was also smaller in cases (P < 0.05). Other parameters showed no significant differences. ROC analysis indicated that lower PTS and narrower intercondylar angle were associated with higher PCL injury risk. CONCLUSION: PTS ≤ 6.5° and an intercondylar angle ≤ 49.5° were associated with a significantly increased risk of PCL injury.