The same slope, a very different knee: age decides how much tibial slope matters

The edition in brief

Today's orthopaedics desk turns on a distinction that changes who gets extra surgery. In 581 primary hamstring-autograft ACL reconstructions followed at least six years, each degree of posterior tibial slope carried an odds ratio of 1.28 (95% CI 1.10 to 1.47) for graft rerupture and each year of age an odds ratio of 0.91 (0.87 to 0.95). There was no interaction between the two (P = 0.685), meaning slope is equally dangerous per degree at every age — but because the baseline risk falls steeply with age, the absolute consequence does not. A 15-degree slope predicts a 36.6% rerupture probability at 18 years and 3.9% at 45. The predicted risk falls below 10% at about 27 years for a 12-degree slope and about 35 years for a 15-degree slope. This is a level 3 retrospective cohort with 38 events, so the thresholds are a way of thinking rather than a rule. Elsewhere, a 12-week double-blind trial in 120 patients added Jintiange capsules, a synthetic tiger-bone traditional Chinese medicine preparation, to celecoxib for knee osteoarthritis and reported a 23.5-point WOMAC fall against 13.2 points on celecoxib alone — but reports both as within-group changes rather than a between-group difference with a confidence interval, which is the number that would tell you whether the difference is real. ABOGRAFT, an international randomised trial, will test tobramycin and vancomycin-impregnated bone graft against placebo graft in 1,100 hip arthroplasties, powered for a 50% reduction in prosthetic joint infection. The C4M study will compare strength against endurance exercise in rheumatoid arthritis, osteoarthritis and sarcopenia in 69 patients.