Posterior Tibial Slope is Increased in Patients With Tibial Tubercle Fractures and Osgood-Schlatter Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Evan Drew Sheppard ◽  
Pradip Ramamurti ◽  
Seth Stake ◽  
Monica Stadecker ◽  
Md Sohel Rana ◽  
...  
Keyword(s):  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Tibial Tubercle ◽  
Posterior Tibial

scholarly journals ACL rupture and posterior tibial slope - how do we handle this?

2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0028
Author(s):  
Jörg Dickschas
Keyword(s):  
Range Of Motion ◽  
Acl Reconstruction ◽  
Plate Osteosynthesis ◽  
Critical Role ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Tibial Tubercle ◽  
Tibial Osteotomy ◽  
Posterior Tibial ◽  
Closed Wedge

Aims and Objectives: In recent publications on acl-ruptures and especially on failure of acl reconstruction there comes a strong focus on posterior tibial slope (PTS). ACL reconstructions with a PTS of >12° have an 8 times higher risk of recurrent instability and reconstruction failure. But many questions stay unclear so far-When do we have to correct the tibial slope? How do we correct it? What about simultaneous frontal axis deviations? In this publication a new algorhythm is presented. Materials and Methods: The following aspects have to be evaluated Is the PTS the only dimension of the deformity or do we have to correct the frontal axis simultaneuosly? Performing a anterior closed wedge extension osteotomy: when do we go distal the tuberosity and when do we perform a tuberosity osteotomy and use it as “bio plating”? Osteosynthesis only screws or always plate? Are there indications for a contineous correction, f.e. with a hexapod? Whats the role of preoperative range of motion of the knee (especially extension)? Always tunnel filling in the same surgery? What about PCL insufficiency and low PTS? Results: An algorhythm is presented giving a treatment path for the different questions mentioned. The procedures are shown step by step in clinical examples and surgery documentation for every pathway. Conclusion: Posterior tibial slope plays an critical role in ACl recontruction. In primary ACl tear a slope correction is probably not indicated. In ACL reconstruction failure a analysis of the PTS needs to be done and correction needs to be discussed. Simultaneuous varus deormities need to be corrected by openwedge valgisation - extension high tibial osteotomy (HTO), while as isolated PTS elevation is subject to an anterior closed wedge extension HTO. Preoperative range of motion needs to be respected not to create hyperextension. Osteosynthesis can be perormed with only screws using the tibial tubercle as “bio-plating”. In cases of former bone-tendeon-bone (BTB) ACL reconstruction a tibial tubercle osteotomy should be avoided and a infratuberositeal osteotomy should be performed and stabilized with plate osteosynthesis. In severe postraumatic cases contineous correction of the slope with fixateur externe, f.e. hexapodes, needs to be performed.

scholarly journals Tibial Tubercle–Sparing Anterior Closing Wedge Osteotomy With Cross-Screw Fixation to Correct Pathologic Posterior Tibial Slope

2021 ◽  
Vol 10 (3) ◽  
pp. e897-e902
Author(s):  
CPT Christian A. Cruz ◽  
CPT Mitchell C. Harris ◽  
CPT Jeffery L. Wake ◽  
CPT Gregory E. Lause ◽  
Brian J. Mannino ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Tibial Tubercle ◽  
Wedge Osteotomy ◽  
Closing Wedge Osteotomy ◽  
Posterior Tibial ◽  
Closing Wedge

scholarly journals Posterior tibial slope: the fingerprint of the tibial bone

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

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

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.

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

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,

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

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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