scholarly journals Association Between Lateral Posterior Tibial Slope, Body Mass Index, and ACL Injury Risk

2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668866 ◽  
Author(s):  
Katherine M. Bojicic ◽  
Mélanie L. Beaulieu ◽  
Daniel Y. Imaizumi Krieger ◽  
James A. Ashton-Miller ◽  
Edward M. Wojtys
Keyword(s):  
Injury Risk ◽  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Multivariate Logistic Regression ◽  
Acl Tear ◽  
Posterior Tibial ◽  
Increased Risk ◽  
Lateral Posterior ◽  
Acl Injury Risk

Background: While body mass index (BMI), a modifiable parameter, and knee morphology, a nonmodifiable parameter, have been identified as risk factors for anterior cruciate ligament (ACL) rupture, the interaction between them remains unknown. An understanding of this interaction is important because greater compressive axial force (perhaps due to greater BMI) applied to a knee that is already at an increased risk because of its geometry, such as a steep lateral posterior tibial slope, could further increase the probability of ACL injury. Purpose: To quantify the relationship between BMI and select knee morphological parameters as potential risk factors for ACL injury. Study Design: Case-control study; Level of evidence, 3. Methods: Sagittal knee magnetic resonance imaging (MRI) files from 76 ACL-injured and 42 uninjured subjects were gathered from the University of Michigan Health System’s archive. The posterior tibial slope (PTS), middle cartilage slope (MCS), posterior meniscus height (PMH), and posterior meniscus bone angle (MBA) in the lateral compartment were measured using MRI. BMI was calculated from demographic data. The association between the knee structural factors, BMI, and ACL injury risk was explored using univariate and multivariate logistic regression. Results: PTS ( P = .043) and MCS ( P = .037) significantly predicted ACL injury risk. As PTS and MCS increased by 1°, odds of sustaining an ACL injury increased by 12% and 13%, respectively. The multivariate logistic regression analysis, which included PTS, BMI centered around the mean (cBMI), and their interaction, showed that this interaction predicted the odds of ACL rupture ( P = .050; odds ratio, 1.03). For every 1-unit increase in BMI from the average that is combined with a 1° increase in PTS, the odds of an ACL tear increased by 15%. Conclusion: An increase in BMI was associated with increased risk of ACL tear in the presence of increased lateral posterior tibial slope. Larger values of PTS or MCS were associated with an increased risk of ACL tear.

scholarly journals Body Mass Index, Modulated by Lateral Posterior Tibial Slope, Predicts ACL Injury Risk

2016 ◽  
Vol 4 (7_suppl4) ◽  
pp. 2325967116S0012
Author(s):  
Katherine M. Bojicic ◽  
Melanie L. Beaulieu ◽  
Daniel Imaizumi Krieger ◽  
James A. Ashton-Miller ◽  
Edward M. Wojtys
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Injury Risk ◽  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Lateral Posterior ◽  
Acl Injury Risk

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 Increased Radiographic Posterior Tibial Slope Is Associated With Subsequent Injury Following Revision Anterior Cruciate Ligament Reconstruction

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711987937 ◽  
Author(s):  
Richard J. Napier ◽  
Enrique Garcia ◽  
Brian M. Devitt ◽  
Julian A. Feller ◽  
Kate E. Webster
Keyword(s):  
Risk Factor ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Revision Acl Reconstruction ◽  
Injury Group ◽  
Anterior Cruciate

Background: Increased posterior tibial slope has been identified as a possible risk factor for injury to the anterior cruciate ligament (ACL) and has also been shown to be associated with ACL reconstruction graft failure. It is currently unknown whether increased posterior tibial slope is an additional risk factor for further injury in the context of revision ACL reconstruction. Purpose: To determine the relationship between posterior tibial slope and further ACL injury in patients who have already undergone revision ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 330 eligible patients who had undergone revision ACL reconstruction between January 2007 and December 2015 were identified from a clinical database. The slope of the medial and lateral tibial plateaus was measured on perioperative lateral radiographs by 2 fellowship-trained orthopaedic surgeons using a digital software application. The number of subsequent ACL injuries (graft rupture or a contralateral injury to the native ACL) was determined at a minimum follow-up of 2 years (range, 2-8 years). Tibial slope measurements were compared between patients who sustained further ACL injury to either knee and those who did not. Results: There were 50 patients who sustained a third ACL injury: 24 of these injuries were to the knee that underwent revision ACL reconstruction, and 26 were to the contralateral knee. Medial and lateral slope values were significantly greater for the third-injury group compared with the no–third injury group (medial, 7.5° vs 6.3° [ P = .01]; lateral, 13.6° vs 11.9° [ P = .001]). Conclusion: Increased posterior tibial slope, as measured from lateral knee radiographs, was associated with increased risk of graft rupture and contralateral ACL injury after revision ACL reconstruction. This is consistent with the concept that increased posterior slope, particularly of the lateral tibial plateau, is an important risk factor for recurrent ACL injury.

Low posterior tibial slope is associated with increased risk of PCL graft failure

2022 ◽  
Author(s):  
Philipp W. Winkler ◽  
Nyaluma N. Wagala ◽  
Sabrina Carrozzi ◽  
Ehab M. Nazzal ◽  
Michael A. Fox ◽  
...  
Keyword(s):  
Graft Failure ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Increased Risk

Age-Related Changes of Posterior Tibial Slope and Its Roles in Anterior Cruciate Ligament Injury

2016 ◽  
Vol 101 (1-2) ◽  
pp. 70-77 ◽  
Author(s):  
Ying-hua Sun ◽  
Lian-xu Chen ◽  
Zhao-de Jiao ◽  
Li Wang ◽  
Rui-ming Zhang ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Curve Fitting ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Age Related ◽  
Anterior Cruciate ◽  
Age Related Changes

Nearly all previous studies in posterior tibial slope (PTS) and anterior cruciate ligament (ACL) injuries ignored age-related changes, and the published data are inconsistent. The objective of this study was to reveal age-related changes of PTS and its roles in ACL injury. Data for 2618 lower limbs were included initially based on the availability of lateral X-rays and a suitable femorotibial angle. The final 1431 subjects were analyzed according to age, sex, side, and injury status. Student t-tests, 1-way analysis of variance, and curve fitting were used to analyze data. The PTS in males was greater than that in females in the 0–9 and 30–39-year-old groups, but this pattern was reversed in the 40–49, 60–69, 70–79, and 80–89-year-old groups. The PTS was greater on the left side than on the right side in the 0–9, 10–19, 50–59, 60–69, and 80–89-year-old groups. The curve fitting for PTS demonstrated a trend of first decreasing and then increasing with aging. The PTS values differed significantly between knees with an ACL injury and those without in the 20–29, 30–39, and 40–49-year-old groups but not in the 50–59-year-old group. The PTS follows a trend of first decreasing and then increasing, and its role in ACL injury changes with advancing age. The higher PTS is only unrelated to the risk of ACL injury in age groups with a lower mean PTS value.

Differences in Medial and Lateral Posterior Tibial Slope: An Osteological Review of 1090 Tibiae Comparing Age, Sex, and Race

2016 ◽  
Vol 45 (1) ◽  
pp. 106-113 ◽  
Author(s):  
Douglas S. Weinberg ◽  
Drew F.K. Williamson ◽  
Jeremy J. Gebhart ◽  
Derrick M. Knapik ◽  
James E. Voos
Keyword(s):  
Cruciate Ligament ◽  
Tibial Slope ◽  
Axial Rotation ◽  
Posterior Tibial Slope ◽  
Normative Values ◽  
Tibial Rotation ◽  
Level Of Evidence ◽  
Posterior Tibial ◽  
Lateral Posterior ◽  
The Mean

Background: Injuries to the anterior cruciate ligament (ACL) are common, and a number of knee morphological variables have been identified as risk factors for an ACL injury, including the posterior tibial slope (TS). However, limited data exist regarding innate population differences in the TS. Purpose: To (1) establish normative values for the medial and lateral posterior TS; (2) determine what differences exist between ages, sexes, and races; and (3) determine how internal or external tibial rotation (as occurs during sagittal knee motion) influences the stereotactic perception of the TS. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 545 cadaveric specimens (1090 tibiae) were obtained from the Hamann-Todd osteological collection. Specimens were leveled in the coronal, sagittal, and axial planes using a digital laser. Virtual representations of each bone were created with a 3-dimensional digitizer apparatus. The TS of the medial and lateral tibial plateaus were measured using techniques adapted from previous radiographic protocols. Medial and lateral TS were then again measured on 200 tibiae that were internally and externally rotated by 10° (axially). Results: The mean (±SD) medial TS was 6.9° ± 3.7° posterior, which was greater than the mean lateral TS of 4.7° ± 3.6° posterior ( P < .001). Neither the medial nor lateral TS changed with age. Women had a greater mean TS compared with men on both the medial (7.5° ± 3.8° vs 6.8° ± 3.7°, respectively; P = .03) and lateral (5.2° ± 3.5° vs 4.6° ± 3.5°, respectively; P = .04) sides. Black specimens had a greater mean medial TS (8.7° ± 3.6° vs 5.8° ± 3.3°, respectively; P < .001) and lateral TS (5.9° ± 3.3° vs 3.8° ± 3.5°, respectively; P < .001) compared with white specimens. Axial rotation was shown to increase the perception of the medial and lateral TS ( P < .001). Conclusion: The medial TS was shown to be greater than the lateral TS. Important sex- and race-based differences exist in the TS. This study also highlights the role of axial rotation in measuring the TS.

scholarly journals Posterior Tibial Slope Angle Correlates With Peak Sagittal and Frontal Plane Knee Joint Loading During Robotic Simulations of Athletic Tasks

2016 ◽  
Vol 44 (7) ◽  
pp. 1762-1770 ◽  
Author(s):  
Nathaniel A. Bates ◽  
Rebecca J. Nesbitt ◽  
Jason T. Shearn ◽  
Gregory D. Myer ◽  
Timothy E. Hewett
Keyword(s):  
Knee Joint ◽  
Slope Angle ◽  
Frontal Plane ◽  
Acl Injury ◽  
Tibial Slope ◽  
Lateral Compartment ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Vertical Jumps ◽  
Posterior Tibial Slope Angle

Background: Tibial slope angle is a nonmodifiable risk factor for anterior cruciate ligament (ACL) injury. However, the mechanical role of varying tibial slopes during athletic tasks has yet to be clinically quantified. Purpose: To examine the influence of posterior tibial slope on knee joint loading during controlled, in vitro simulation of the knee joint articulations during athletic tasks. Study Design: Descriptive laboratory study. Methods: A 6 degree of freedom robotic manipulator positionally maneuvered cadaveric knee joints from 12 unique specimens with varying tibial slopes (range, −7.7° to 7.7°) through drop vertical jump and sidestep cutting tasks that were derived from 3-dimensional in vivo motion recordings. Internal knee joint torques and forces were recorded throughout simulation and were linearly correlated with tibial slope. Results: The mean (±SD) posterior tibial slope angle was 2.2° ± 4.3° in the lateral compartment and 2.3° ± 3.3° in the medial compartment. For simulated drop vertical jumps, lateral compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee adduction ( r = 0.60-0.65), flexion ( r = 0.64-0.66), lateral ( r = 0.57-0.69), and external rotation torques ( r = 0.47-0.72) as well as inverse correlations with peak abduction ( r = −0.42 to −0.61) and internal rotation torques ( r = −0.39 to −0.79). Only frontal plane torques were correlated during sidestep cutting simulations. For simulated drop vertical jumps, medial compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee flexion torque ( r = 0.64-0.69) and lateral knee force ( r = 0.55-0.74) as well as inverse correlations with peak external torque ( r = −0.34 to −0.67) and medial knee force ( r = −0.58 to −0.59). These moderate correlations were also present during simulated sidestep cutting. Conclusion: The investigation supported the theory that increased posterior tibial slope would lead to greater magnitude knee joint moments, specifically, internally generated knee adduction and flexion torques. Clinical Relevance: The knee torques that positively correlated with increased tibial slope angle in this investigation are associated with heightened risk of ACL injury. Therefore, the present data indicated that a higher posterior tibial slope is correlated to increased knee loads that are associated with heightened risk of ACL injury.

Change in Posterior Tibial Slope in Skeletally Immature Patients With Anterior Cruciate Ligament Injury: A Case Series With a Mean 9 Years’ Follow-up

2021 ◽  
pp. 036354652199709
Author(s):  
R. Kyle Martin ◽  
Guri R. Ekås ◽  
JūratėŠaltytė Benth ◽  
Nicholas Kennedy ◽  
Gilbert Moatshe ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Case Series ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Skeletally Immature ◽  
Posterior Tibial ◽  
Lateral Posterior ◽  
The Mean ◽  
Injured Knee

Background: Increased lateral posterior tibial slope (LPTS) is associated with increased rates of anterior cruciate ligament (ACL) injury and failure of ACL reconstruction. It is unknown if ACL deficiency influences the developing proximal tibial physis and slope in skeletally immature patients through anterior tibial subluxation and abnormal force transmission. Purpose: To assess the natural history of LPTS in skeletally immature patients with an ACL-injured knee. Study Design: Case series; Level of evidence, 4. Methods: A total of 38 participants from a previous study on nonoperative management of ACL injury in skeletally immature patients were included. During the initial study, bilateral knee magnetic resonance imaging (MRI) was performed within 1 year of enrollment and again at final follow-up. All patients were younger than 13 years at the time of enrollment, and final follow-up occurred a mean 10 years after the injury. MRI scans were retrospectively reviewed by 2 reviewers to determine bilateral LPTS for each patient and each time point. Linear mixed models were used to assess LPTS differences between knees, change over time, and association with operational status. Subgroup analyses were performed for patients who remained nonoperated throughout the study. Results: A total of 22 patients had ACL reconstruction before final follow-up and 16 remained nonoperated. In the entire study population, the mean LPTS was higher in the injured knee than in the contralateral knee at final follow-up by 2.0° ( P < .001; 95% CI, 1.3°–2.6°). The mean LPTS increased significantly in the injured knee by 0.9° ( P = .042; 95% CI, 0.03°–1.7°), while the mean LPTS decreased in the contralateral knee by 0.4° ( P = .363; 95% CI, –0.8° to 0.4°). A significant difference in LPTS was also observed in the nonoperated subgroup. No significant association was observed between LPTS and operational status. Conclusion: Lateral posterior tibial slope increased more in the ACL-injured knee than in the contralateral uninjured knee in a group of skeletally immature patients. Lateral posterior tibial slope at baseline was not associated with the need for surgical reconstruction over the study period.

scholarly journals Radiographic evaluation of posterior tibial slope in ACL deficient Indian patients

2019 ◽  
Vol 5 (3) ◽  
pp. 473
Author(s):  
Ravi Kumar ◽  
Kishore Kunal
Keyword(s):  
Standard Deviation ◽  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Notch Width ◽  
Indian Patients ◽  
History Of ◽  
The Mean ◽  
Acl Deficient

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> 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. </p>

Sign in / Sign up

Export Citation Format

Share Document