Patellar tendon angle is not elevated in ACL‐injured subjects, suggesting methods to correct should focus on prehabilitation and rehabilitation rather than surgery

Purpose The aim of the study was to explore if the patellar tendon angles (PTAs) is an intrinsic risk factor for anterior cruciate ligament (ACL) rupture. We hypothesised that the PTAs will be increased in ACL rupture patients compared to matched controls. Methods We performed a retrospective radiographic cohort study. A cohort of ACL‐injured patients between 2019 and 2022 was utilised. The control population, from the same time period, was a consecutive series of 100 patients without ligament or meniscal injuries which were prospectively added to our institutional registry. Posterior tibial slope (PTS), static anterior tibial translation (SATT), patellar tendon to tibial plateau angle (PT‐TPA), patellar tendon‐tibial shaft angle (PT‐TSA) were measured. Results A total of 100 patients were included in the control cohort and 110 in the ACL cohort. The PT‐TPA was significantly less in the ACL cohort compared to the control cohort, mean and SD of 15.33 (±5.74) versus 13.91 (±5.68), respectively (p = 0.01). PT‐TSA was also less in the ACL cohort, mean and SD of 116.15 (±5.89) versus 114.27 (±4.81), however, this failed to reach statistical significance (p = 0.08). The PT‐TPA was not correlated with PTS (p = 0.65) and the PT‐TSA was inversely correlated with PTS; Pearson correlation coefficient of −0.28 (p