Role of posterior tibial slope in ACL deficient Indian population

Background: There are several studies which have investigated various osseous morphologic characteristics as they relate to ACL injury. Tibial slope, notch width, and notch width index are some. However, there does not appear to be consensus across studies. The aim of this study was to validate association between posterior tibial slope (PTS) and ACL injury in an ACL deficient knee of Indian patients.Methods: This retrospective cum prospective study was done at a tertiary hospital from June 2017 to May 2018. 40 patients were included. Inclusion criteria were documented evidence of ACL tear to the affected knee; no history of osteoarthritis; no history of rheumatoid arthritis; patients voluntarily consented for the use of their radiographs for the study. The assessment was completed with a true lateral view of the knee with full length leg and ankle. The functional tibial slope as described by Julliard et al was used to determine the PTS. The mean and standard deviation (SD) for medial PTS were measured. Demographic data like age, sex were collected and entered into a database.Results: 95% of patients were male. Mean age was 29.25. The mean PTS was 13.037 which is reasonably high as compared to normal while the standard deviation was 4.487 reflecting large amount of variation.Conclusions: Increased posterior tibial slope can be concluded as a significant risk factor in ACL injury which corroborates the findings of various previously published studies. The findings presented may help identify patients who are at greater risk of ACL injury.

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An Observation of Posterior Tibial Slope and Metaphysio-diaphyseal Angle in Indian Population

10.5005/jp-journals-10079-1023 ◽

2020 ◽

Vol 2 (2) ◽

pp. 52-56

Author(s):

Vasudevan Thirunarayanan ◽

Dhurvas R Ramprasath ◽

Ramachandran Amarnath ◽

Velmani Arun

Keyword(s):

Indian Population ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Posterior Tibial

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Measurement of Posterior Tibial Slope in North Indian population in relation to squaing

Journal of Bone and Joint Diseases ◽

10.13107/jbjd.2020.v35i02.015 ◽

2020 ◽

Vol 35 (2) ◽

pp. 14-18

Author(s):

Khalid Ahmad Qidwai ◽

Shakeel Ahmad Qidwai

Keyword(s):

Indian Population ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

North Indian Population ◽

Posterior Tibial

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Coronal Lateral Collateral Ligament Sign: A Novel Magnetic Resonance Imaging Sign for Identifying Anterior Cruciate Ligament–Deficient Knees in Adolescents and Summarizing the Extent of Anterior Tibial Translation and Femorotibial Internal Rotation

The American Journal of Sports Medicine ◽

10.1177/0363546521988938 ◽

2021 ◽

Vol 49 (4) ◽

pp. 928-934

Author(s):

Brendon C. Mitchell ◽

Matthew Y. Siow ◽

Tracey Bastrom ◽

James D. Bomar ◽

Andrew T. Pennock ◽

...

Keyword(s):

Magnetic Resonance ◽

Internal Rotation ◽

Cruciate Ligament ◽

Lateral Collateral Ligament ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Anterior Tibial Translation ◽

Posterior Tibial ◽

Tibial Translation ◽

Acl Deficient

Background: Incompetence of the anterior cruciate ligament (ACL) confers knee laxity in the sagittal and axial planes that is measurable with clinical examination and diagnostic imaging. Hypothesis: An ACL-deficient knee will produce a more vertical orientation of the lateral collateral ligament (LCL), allowing for the entire length of the LCL to be visualized on a single coronal slice (coronal LCL sign) on magnetic resonance imaging. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Charts were retrospectively reviewed from April 2009 to December 2017 for all patients treated with ACL reconstruction (constituting the ACL-deficient cohort). A control cohort was separately identified consisting of patients with a normal ACL and no pathology involving the collateral ligaments or posterior cruciate ligament. Patients were excluded for follow-up <2 years, incomplete imaging, and age >19 years. Tibial translation and femorotibial rotation were measured on magnetic resonance images, and posterior tibial slope was measured on a lateral radiograph of the knee. Imaging was reviewed for the presence of the coronal LCL sign. Results: The 153 patients included in the ACL-deficient cohort had significantly greater displacement than the 70 control patients regarding anterior translation (5.8 vs 0.3 mm, respectively; P < .001) and internal rotation (5.2° vs −2.4°, P < .001). Posterior tibial slope was not significantly different. The coronal LCL sign was present in a greater percentage of ACL-deficient knees than intact ACL controls (68.6% vs 18.6%, P < .001). The presence of the coronal LCL sign was associated with greater anterior tibial translation (7.2 vs 0.2 mm, P < .001) and internal tibial rotation (7.5° vs –2.4°, P = .074) but not posterior tibial slope (7.9° vs 7.9°, P = .973) as compared with its absence. Multivariate analysis revealed that the coronal LCL sign was significantly associated with an ACL tear (odds ratio, 12.8; P < .001). Conclusion: Our study provides further evidence that there is significantly more anterior translation and internal rotation of the tibia in the ACL-deficient knee and proves our hypothesis that the coronal LCL sign correlates with the presence of an ACL tear. This coronal LCL sign may be of utility for identifying ACL tears and anticipating the extent of axial and sagittal deformity.

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Posterior tibial slope: the fingerprint of the tibial bone

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-021-06578-9 ◽

2021 ◽

Author(s):

Philipp W. Winkler ◽

Brian M. Godshaw ◽

Jon Karlsson ◽

Alan M. J. Getgood ◽

Volker Musahl

Keyword(s):

Tibial Slope ◽

Posterior Tibial Slope ◽

Posterior Tibial ◽

Tibial Bone

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What is the impact of knee morphology on posterior cruciate ligament avulsion fracture in men and women: a case control study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03984-5 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ning Fan ◽

Yong-chen Zheng ◽

Lei Zang ◽

Cheng-gang Yang ◽

Shuo Yuan ◽

...

Keyword(s):

Avulsion Fracture ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Control Groups ◽

Posterior Tibial ◽

Notch Width ◽

Lateral Posterior ◽

And Control ◽

Pcl Avulsion ◽

Notch Width Index

Abstract Background Several studies on the relationship between morphological parameters and traumatic diseases of the knee have already been conducted. However, few studies focused on the association between knee morphology and posterior cruciate ligament (PCL) avulsion fracture in adults. The objective of this study was to evaluate the impact of knee morphology on PCL avulsion fracture. Methods 76 patients (comprised 40 men and 36 women) with PCL avulsion fracture and 76 age- and sex-matched controls without PCL avulsion fracture were studied from 2012 to 2020. MRI measurements of the knee were acquired in the sagittal, coronal, and axial planes. The assessed measurements including intercondylar notch width index, coronal tibial slope, and medial/lateral posterior tibial slopes were compared between men and women, and between case and control groups respectively using independent sample t-tests. In addition, binary logistic regression analyses were used to identify independent risk factors of PCL avulsion fracture. Results Except notch width index (coronal) (p = 0.003) in the case groups, there was no statistical difference in the assessed measurements including notch width index (axial), coronal tibial slope, medial posterior tibial slope, and lateral posterior tibial slope between men and women in the case and control groups (p > 0.05). When female patients were analyzed, the notch width index (coronal) was significantly smaller (p = 0.0004), the medial posterior tibial slope (p = 0.018) and the lateral posterior tibial slope (p = 0.033) were significantly higher in the case group. The binary logistic regression analysis showed that the notch width index (coronal) (B = -0.347, OR = 0.707, p = 0.003) was found to be an independent factor of PCL avulsion fracture. However, none of the assessed measurements was found to have a statistical difference between the case and control groups in men (p > 0.05). Conclusions Notch width index (coronal), medial posterior tibial slope, and lateral posterior tibial slope were found to affect PCL avulsion fracture in women, but no such measurements affected the PCL avulsion fracture in men. Furthermore, a smaller notch width index (coronal) in women was found to be a risk factor in PCL avulsion fracture.

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Effect of Posterior Tibial Slope Change on Postoperative Range of Motion and Clinical Outcomes after Posterior Cruciate-Substituting Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0041-1729967 ◽

2021 ◽

Author(s):

O-Sung Lee ◽

Jangyun Lee ◽

Myung Chul Lee ◽

Hyuk-Soo Han

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Correlation Coefficient ◽

Knee Arthroplasty ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Posterior Tibial ◽

Clinical Scores ◽

Total Knee ◽

The Mean

AbstractThe posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ± 3.4 and 120.1 ± 15.4 degrees preoperatively to 2.0 ± 1.3 and 128.4 ± 9.3 degrees postoperatively, and the mean PTS change was 7.6 ± 3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA,

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Measurement of femoral posterior condylar offset and posterior tibial slope in normal knees based on 3D reconstruction

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04367-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Liangxiao Bao ◽

Shengwei Rong ◽

Zhanjun Shi ◽

Jian Wang ◽

Yang Zhang

Keyword(s):

Three Dimensional ◽

Surgical Techniques ◽

Inverse Correlation ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Lateral Side ◽

Posterior Condylar Offset ◽

Posterior Tibial ◽

Significant Difference ◽

Posterior Condylar

Abstract Background Femoral posterior condylar offset (PCO) and posterior tibial slope (PTS) are important for postoperative range of motion after total knee arthroplasty (TKA). However, normative data of PCO and PTS and the correlation between them among healthy populations remain to be elucidated. The purpose of this study was to determine PCO and PTS in normal knees, and to identify the correlation between them. Methods Eighty healthy volunteers were recruited. CT scans were performed followed by three-dimensional reconstruction. PCO and PTS were measured and analyzed, as well as the correlation between them. Results PTS averaged 6.78° and 6.11°, on the medial and lateral side respectively (P = 0.002). Medial PCO was greater than lateral (29.2 vs. 23.8 mm, P < 0.001). Both medial and lateral PCO of male were larger than female. On the contrary, male medial PTS was smaller than female, while there was no significant difference of lateral PTS between genders. There was an inverse correlation between medial PCO and PTS, but not lateral. Conclusions Significant differences exhibited between medial and lateral compartments, genders, and among individuals. An inverse correlation exists between PCO and PTS in the medial compartment. These results improve our understanding of the morphology and biomechanics of normal knees, and subsequently for optimising prosthetic design and surgical techniques.

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