Abstract
<title>Abstract</title> <p>Background The lateral tibial slope (LTS) plays a crucial role in knee biomechanics by influencing anterior tibial translation and anterior cruciate ligament (ACL) loading. Increased LTS has been proposed as an important anatomical risk factor for ACL injury, though clinical evidence remains variable. Objective To evaluate the relationship between lateral tibial slope and ACL injury and to analyze associated demographic and injury-related factors. Methods This prospective observational study was conducted at a tertiary care centre over one year and included 30 patients aged 18–55 years with MRI-confirmed complete ACL tears. Lateral tibial slope was measured on MRI, and statistical analysis was performed to assess its association with ACL injury characteristics. Results Of the 30 patients, 73.33% were males, with the highest incidence of ACL injury observed in the 18–25-year age group (43.33%). Sports-related trauma was the most common mechanism of injury (46.67%). The mean lateral tibial slope was 11.75 ± 1.37°, higher than reported normal values. Patients with a history of fall had the highest mean LTS (13.04 ± 1.35°). A strong positive correlation was observed between lateral tibial slope and ACL injury characteristics (Spearman’s ρ = 0.875; p < 0.05), indicating that increased LTS is significantly associated with ACL injury. Conclusion Increased lateral tibial slope is significantly associated with ACL injury, particularly among young, active males.</p>