scholarly journals IS OSGOOD-SCHLATTER DISEASE TRULY A BENIGN KNEE CONDITION? A PILOT STUDY DEMONSTRATING INCREASED POSTERIOR TIBIAL SLOPE

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0028
Author(s):  
Daniel W. Green ◽  
Sreetha Sidharthan ◽  
Lindsay M. Schlichte
Keyword(s):  
Patellar Tendon ◽  
Interrater Reliability ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Ossification Center ◽  
Control Group ◽  
X Rays ◽  
X Ray ◽  
Posterior Tibial ◽  
And Control

Background: Osgood-Schlatter disease (OSD) is a traction apophysitis caused by repetitive strain and chronic avulsion of the secondary ossification center of the tibal tuberosity from the patellar tendon. Purpose: The aim of this study was to determine if OSD is associated with increased posterior tibial slope (PTS). Methods: A total of 40 knees with OSD and 32 control knees examined by the senior author between 2008 and 2019 were included. Patients aged 10 to 15 years old with clinical diagnosis of OSD supported by radiographic findings on lateral X-ray and MRI were eligible. Age- and sex-matched subjects with history of anterior knee pain but no evidence of OSD on clinical exam and no fragmentation of the tibial tubercle on lateral X-Ray and MRI were included in the control group. PTS was defined as the angle between the reference line and a line drawn tangent to the uppermost anterior and posterior edges of the medial tibial plateau. Measurements were carried out in duplicate on true lateral X-Rays by two blinded investigators. Interrater reliability of posterior tibial slope measurements between the two examiners was evaluated using intraclass correlation coefficient (ICC). Independent-sample student t-test was used to compare PTS in the OSD and control knees. Results: Mean age at time of lateral radiograph was 12.6 ± 1.6 years and 51% (37/72) of knees were male. There were no differences in age, sex, and laterality of knees between the OSD and control groups. Mean PTS was significantly higher in the OSD group (12.23º ± 3.58º) compared to the control group (8.82 º ± 2.76 º, p<0.001) (Figure 1). ICC was 0.931 (95% confidence interval, 0.890 to 0.957) for measurement of PTS between the two examiners, indicating almost perfect interrater reliability. Conclusion: This study is the first to identify an association between OSD and increased PTS. The clinical implications of this novel finding have not yet been elucidated. However, several studies have demonstrated that increased PTS is a risk factor for ACL injury and re-tear. It may be speculated in patients with OSD, stress from the extensor mechanism through the patellar tendon loads the anterior portion of the tibia disproportionately to the posterior segment, thereby resulting in asymmetric growth and an increased PTS. [Figure: see text]

Increased Posterior Tibial Slope in Patients With Osgood-Schlatter Disease: A New Association

2020 ◽  
Vol 48 (3) ◽  
pp. 642-646
Author(s):  
Daniel W. Green ◽  
Sreetha Sidharthan ◽  
Lindsay M. Schlichte ◽  
Alexandra H. Aitchison ◽  
Douglas N. Mintz
Keyword(s):  
Patellar Tendon ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Tibial Slope ◽  
Lateral Radiograph ◽  
Posterior Tibial Slope ◽  
Control Group ◽  
Posterior Tibial ◽  
The Mean ◽  
And Control

Background: Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tubercle caused by repetitive strain and chronic avulsion from the patellar tendon. No widely accepted anatomic risk factors have been associated with OSD. Purpose: To determine if OSD is associated with increased posterior tibial slope (PTS). Study Design: Cross-sectional study; Level of evidence, 3. Methods: Forty knees with OSD and 32 control knees examined by the senior author between 2008 and 2019 were included. Patients 10 to 15 years of age with a clinical diagnosis of OSD and available lateral radiograph and magnetic resonance imaging (MRI) were eligible. Age- and sex-matched patients with a history of knee pain but no evidence of OSD on clinical examination and without significant pathology on lateral radiograph and MRI were included in the control group. PTS was defined as the angle between a reference line perpendicular to the proximal anatomic axis and a line drawn tangent to the uppermost anterior and posterior edges of the medial tibial plateau. Measurements were carried out in duplicate on true lateral radiographs by 2 blinded investigators. Interrater reliability of PTS measurements was evaluated using intraclass correlation coefficient (ICC). The independent samples t test was used to compare PTS between the OSD and control knees. Results: The mean age was 12.6 ± 1.6 years and 51% (37/72) of the knees were from male youth. There were no differences in age, sex, and laterality of knees between the OSD and control groups. The mean PTS was significantly higher in the OSD group (12.23°± 3.58°) compared with the control group (8.82°± 2.76°; P < .001). The ICC was 0.931 (95% CI, 0.890-0.957), indicating almost perfect interrater reliability. Conclusion: This study identifies an association between OSD and increased PTS. The clinical implications of this finding have not yet been elucidated. It may be speculated that in patients with OSD, stress from the extensor mechanism through the patellar tendon loads the anterior portion of the tibia disproportionately to the posterior segment, thereby resulting in asymmetric growth and an increased PTS.

scholarly journals KNEE RADIOGRAPHS DEMONSTRATE SMALL BUT STATISTICALLY SIGNIFICANT INCREASE IN POSTERIOR TIBIAL SLOPE IN PATIENTS WITH OSGOOD-SCHLATTER DISEASE

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0012
Author(s):  
Daniel W. Green ◽  
Alexandra H. Aitchison ◽  
Sreetha Sidharthan ◽  
Lindsay M. Schlichte ◽  
Peter D. Fabricant ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Control Group ◽  
X Ray ◽  
Clinical Exam ◽  
Posterior Tibial ◽  
Knee Pathology

Background: Previous research has demonstrated an association between Osgood-Schlatter disease (OSD) and increased posterior tibial slope (PTS) in a small subset of patients with MRI and clinical exam consistent with OSD. Hypothesis/Purpose: To determine if children diagnosed clinically with OSD have an increased PTS on routine radiographs compared to controls. Methods: Patients 10-18 years old with the clinical diagnosis of OSD and a true lateral knee X-ray between 2016 and 2019 were eligible for the OSD group. Subjects were excluded if they had other significant knee pathology (Figure 1). The same number of controls were selected from patients in the same age and date range with history of anterior knee pain and a true lateral knee X-ray but no evidence of OSD or other significant pathology on clinical exam or X-ray. Demographic data and HSS Functional Activity Brief Scale (HSS Pedi-FABS) scores were collected for each subject. PTS measurements were performed on true lateral X-Rays by three blinded investigators. Independent samples t-test and chi-squared test were used to compare variable means and frequency between OSD and control knees. Logistic regression analysis was used to investigate the effects of OSD, age, sex, height, weight, and HSS Pedi-FABS score on PTS (≥12º versus <12º). Results: 258 total knees (129 with OSD and 129 controls) were included. Mean age was 12.9 ± 1.8 years and 53% knees were male. There were no differences in age, sex, BMI, or laterality of knees between groups (Table 1). Mean PTS was significantly higher in the OSD group (11.6º ± 2.9º) compared to the control group (9.3º ± 2.7º, p<0.0001). In the OSD group, 46% of knees had a PTS ≥12º and in the control group, 19% knees had a PTS >12º (p<0.001). Logistic regression analysis showed that patients with OSD had 3.63 greater odds (95% CI 1.78-7.40) of having PTS ≥12º compared to patients without OSD, when controlling for age, sex, height, weight, and HSS Pedi-FABS score (Table 2). Conclusion: This study further supports an association between OSD and a mild increase in PTS. Patients with OSD had 3.6 greater odds of having PTS≥12º. The clinical implications of this finding have not yet been elucidated. We speculate that in patients with OSD, stresses (or force) exerted from the quadriceps muscle group through the patellar tendon loads the anterior portion of the tibia tubercle disproportionately to the posterior segment and causes asymmetric growth and an increased PTS. Tables/ Figures [Table: see text][Table: see text][Figure: see text]

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.

Steep Posterior Tibial Slope, Anterior Tibial Subluxation, Deep Posterior Lateral Femoral Condyle, and Meniscal Deficiency Are Common Findings in Multiple Anterior Cruciate Ligament Failures: An MRI Case-Control Study

2019 ◽  
Vol 47 (2) ◽  
pp. 285-295 ◽  
Author(s):  
Alberto Grassi ◽  
Luca Macchiarola ◽  
Francisco Urrizola Barrientos ◽  
Juan Pablo Zicaro ◽  
Matias Costa Paz ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Tibial Slope ◽  
Lateral Femoral Condyle ◽  
Posterior Tibial Slope ◽  
Control Group ◽  
Medial Tibial Plateau ◽  
Posterior Tibial ◽  
Anterior Tibial

Background: Tibiofemoral anatomic parameters, such as tibial slope, femoral condyle shape, and anterior tibial subluxation, have been suggested to increase the risk of anterior cruciate ligament (ACL) reconstruction failure. However, such features have never been assessed among patients experiencing multiple failures of ACL reconstruction. Purpose: To compare the knee anatomic features of patients experiencing a single failure of ACL reconstruction with those experiencing multiple failures or with intact ACL reconstruction. Study: Case-control study; Level of evidence, 3. Methods: Twenty-six patients who experienced failure of revision ACL reconstruction were included in the multiple-failure group. These patients were matched to a group of 25 patients with failure of primary ACL reconstruction and to a control group of 40 patients who underwent primary ACL reconstruction with no failure at a minimum follow-up of 24 months. On magnetic resonance imaging (MRI), the following parameters were evaluated: ratio between the height and depth of the lateral and medial femoral condyles, the lateral and medial tibial plateau slopes, and anterior subluxation of the lateral and medial tibial plateaus with respect to the femoral condyle. The presence of a meniscal lesion during each procedure was evaluated as well. Anatomic, demographic, and surgical characteristics were compared among the 3 groups. Results: The patients in the multiple-failure group had significantly higher values of lateral tibial plateau slope ( P < .001), medial tibial plateau slope ( P < .001), lateral tibial plateau subluxation ( P < .001), medial tibial plateau subluxation ( P < .001), and lateral femoral condyle height/depth ratio ( P = .038) as compared with the control group and the failed ACL reconstruction group. Moreover, a significant direct correlation was found between posterior tibial slope and anterior tibial subluxation for the lateral ( r = 0.325, P = .017) and medial ( r = 0.421, P < .001) compartments. An increased anterior tibial subluxation of 2 to 3 mm was present in patients with a meniscal defect at the time of the MRI as compared with patients who had an intact meniscus for both the lateral and the medial compartments. Conclusion: A steep posterior tibial slope and an increased depth of the lateral femoral condyle represent a common finding among patients who experience multiple ACL failures. Moreover, higher values of anterior subluxation were found among patients with repeated failure and those with a medial or lateral meniscal defect.

Posterior tibial slope of the knee measured on X-rays in a Turkish population

2020 ◽  
Vol 42 (6) ◽  
pp. 673-679
Author(s):  
Ismail Eralp Kacmaz ◽  
Yuksel Topkaya ◽  
Can Doruk Basa ◽  
Vadym Zhamilov ◽  
Ali Er ◽  
...  
Keyword(s):  
Tibial Slope ◽  
Turkish Population ◽  
Posterior Tibial Slope ◽  
X Rays ◽  
Posterior Tibial

scholarly journals Is it possible to avoid posterior tibial slope increase in open-wedge high tibial osteotomy?

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0005
Author(s):  
Hüseyin Kaya ◽  
Elcil Kayabiçer ◽  
Ali Engin Daştan ◽  
Emin Taşkıran
Keyword(s):  
High Tibial Osteotomy ◽  
Tibial Slope ◽  
Statistical Analyses ◽  
Posterior Tibial Slope ◽  
Tibial Osteotomy ◽  
X Rays ◽  
Open Wedge ◽  
P Values ◽  
Posterior Tibial ◽  
Wedge High Tibial Osteotomy

Aim: Posterior tibial slope has shown to be increased with open-wedge high tibial osteotomy (OWHTO) which may lead to an increase in loading of the anterior cruciate ligament and causing patellofemoral problems in return. In this case series, patients with an OWHTO performed posteromedial to the medial collateral ligament (MCL), keeping it intact was investigated. The aim of this study was to evaluate the influence of this technique on the posterior tibial slope. Methods: Thirty knees (15 right, 15 left) of 28 patients (22 women, 6 men) with a mean age of 53.57±5.9 years who had an OWHTO between January 2014 and February 2016 were included in this study. Surgical technique: A proximal tibial osteotomy is performed posteromedial to MCL keeping it intact. Following the osteotomy, distraction is also performed from the posteromedial aspect of tibia. Fixation is achieved utilizing TomoFix plate. Radiological evaluation: Preoperative and postoperative mechanical axes (MA) were measured on standard weight bearing long axis x-rays. Preoperative and postoperative posterior tibial slope angles were measured on lateral x-rays using three different Methods: the angles between medial tibial plateau and (1) posterior tibial cortex, (2) tibial proximal anatomical axis, and (3) posterior fibular cortex were measured. The correlations of three different measurement methods were analyzed. Patients were grouped according to preoperative MA deviations and postoperative MA changes (either <10º or >=10º). The posterior tibial slope changes were compared between groups. Statistical analyses: All statistical analyses were performed utilizing SPSS 18.0. Results: Mean preoperative and postoperative MA deviations were 9.81°±4.94° and -2.72°± 2.69° respectively. The mean correction angle of MA of lower extremity was 12.62°±4.58°. The three methods used to measure the posterior tibial slope angles were found to be highly correlated with each other ((1) and (2) r=0.961; (1) and (3) 0.906; (2) and (3) 0.934; p values <0.0001). Preoperative mean posterior tibial slope angles were 9.50º±4.47°, 11.51º± 4.50°, and 10.80º±4.58°; postoperative angles were 6.10º±4.23°, 8.78º±4.57° and 8.11º±4.55°, respectively. Posterior tibial slope angle was significantly decreased postoperatively with respect to all three methods (p <0.0001). The changes in the posterior tibial slope was not statistically significant between the groups with preoperative <10º and >=10º deformities (p values 0.861, 0.723, 0.727, respectively). Conclusions: Posterior tibial slope was found to be decreased with this posteromedial OWHTO technique. This technique offered the advantage of preserving the posterior tibial slopes postoperatively even in highly deformed knees which necessitated higher degrees of corrections in the mechanical axes.

scholarly journals Varus and Steep Medial Posterior Tibial Slope Are Risk Factors for Degenerative Medial Meniscus Lesions

2021 ◽  
Author(s):  
Tao Xu ◽  
Liuhai Xu ◽  
Xinzhi Li ◽  
You Zhou
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Medial Meniscus ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Control Group ◽  
Test Analysis ◽  
Posterior Tibial ◽  
Meniscus Lesions ◽  
Experimental Group

Abstract Purpose: Degenerative medial meniscus lesions(DMMLs) is different from other meniscus injuries, which have a high incidence and easy to miss diagnosis in the middle-aged and elderly. The present study was designed to identify the risk factors for DMMLs among an Asian sample.Methods: The experimental group included 121 patients（ones partly confirmed during arthroscopic surgery) with DMMLs and the control group included 51 patients with no pathological changes identified by using 3.0-T magnetic resonance imaging (MRI) from January 2017 to January 2021 were analyzed retrospectively. By full-length anteroposterior radiographs of lower limbs in weight-bearing position of the two groups, the Hip-Knee-Ankle (HKA) angle in the coronal plane and the Medial Posterior Tibial Slope(MPTS) in the sagittal plane were measured by the MRI T1 sequence of the knee. The potential risk factors of DMMLs were analyzed by multivariate logistic regression. The independent variables included gender, age, body mass index (BMI), occupational kneeling, Kellgren-Lawrence (K-L) grade, HKA, and MPTS.Results: T-test analysis between the Experimental Group and the Control Group showed statistically significant differences in age (t=10.718, p<0.001), BMI (t=7.300, p<0.001), HKA (t=8.677, p<0.001), and MPTS (t=5.025, p<0.001). Chi-square test analysis between the two groups showed no statistically significant differences in gender (t=0.183, p=0.669) and occupational kneeling (t=0.339, p=0.560). Non-parametric analysis showed statistically significant differences in K-L (z=5.857, p<0.001) between the two groups. Logistic regression analysis showed that age, BMI, HKA, and MPTS were risk factors for DMMLs among the above-mentioned variables with statistically significant differences.Conclusions: varus, steep MPTS, advancing age and obesity were risk factors for DMMLs.

scholarly journals Posterior tibial slope in patients undergoing anterior cruciate ligament (ACL) reconstruction with patellar tendon autograft: Analysis of subsequent ACL graft tear or contralateral ACL tear

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0035
Author(s):  
Rodney Benner ◽  
Jonathan Jones ◽  
Tinker Gray ◽  
K. Donald Shelbourne
Keyword(s):  
Acl Reconstruction ◽  
Patellar Tendon ◽  
Revision Surgery ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Acl Tear ◽  
Posterior Tibial ◽  
Revision Acl Reconstruction ◽  
The Mean ◽  
Tendon Autograft

Objectives: To examine the relationship of posterior tibial slope and rate of graft tear or contralateral anterior cruciate ligament (ACL) tear among patients undergoing primary or revision ACL reconstruction with patellar tendon autograft. Methods: From June 2001 to 2015, 2,796 patients received primary or revision ACL reconstruction with patellar tendon autograft (PTG) and were followed prospectively to determine rate of graft tear and contralateral ACL tear. Minimum follow-up for study inclusion was 4 years. Posterior tibial slope (PTS) was measured preoperatively on digital lateral view radiographs with knee flexion between 30° and 45°. Intersecting lines were drawn along the medial tibial plateau and the posterior tibia; the value of the acute angle at the lines’ intersection was then subtracted from 90° to obtain the PTS. This procedure was carried out by a clinical assistant with interrater reliability of 0.89. Chi-square analysis, Pearson correlation, and t-tests were used to determine relationships between rate of graft tear or contralateral ACL tear and PTS, age, and sex among primary and revision surgery groups. A threshold of PTS ≥10° was used for analysis. Results: The mean age of patients was 24.3±10.2 years for patients undergoing primary ACL reconstruction (n=2472) and 24.3±8.8 years for revision ACL reconstruction (n=324). The mean follow-up time was 11.6 ± 4.0 years. The rate of primary graft tear was 5.1% (n=126), and primary contralateral ACL tear rate was 4.9% (n=121). The rate of revision graft tear was 5.9% (n=19), and revision contralateral tear rate was 1.9% (n=6). Among primary reconstructions, the mean surgery age of patients who experienced graft tear (19.2 ± 6.3 years) or contralateral tear (21.5 ± 9.5 years) were significantly younger (P<.001, P=.0011, respectively) than patients who did not suffer a subsequent tear (24.7 ± 10.3 years). The mean PTS among primary graft tears was 5.4 ± 3.1°, which was statistically significantly higher than the mean of 4.8 ± 2.9° for patients without tear (P=.041). The mean PTS was 4.9 ± 3.3° for patients with contralateral tears, which was not statistically significant different than other groups. Furthermore, primary reconstruction patients with PTS≥10° had a significantly higher rate of graft tear (9.6%) than patients with PTS ≤9° (4.7%) (P=0.004), but not a higher rate of contralateral tear. Among patients undergoing revision surgery, there were no statistically significant differences between graft tear, contralateral tear, and no tear groups with relation to age, PTS, or PTS ≥10°. Among all patients (primary or revision group), there was no difference in PTS between sexes (P=0.278), nor was surgery age significantly correlated to PTS (R=0.0226). Conclusion: Higher PTS appears to be correlated to higher rates of ACL graft tear in patients undergoing primary ACL reconstruction with PTG, particularly when PTS is greater than 10°. However, rate of graft tear remains low (5.1% overall, 9.6% with PTS≥10°). Furthermore, for patients undergoing revision surgery, there is no significant association between PTS and rate of subsequent tear. Therefore, caution should be exercised when considering more radical interventions, such as osteotomy, to prevent retear in patients with high PTS.

Medial Meniscal Posterior Horn Tears Are Associated With Increased Posterior Tibial Slope: A Case-Control Study

2020 ◽  
Vol 48 (7) ◽  
pp. 1702-1710 ◽  
Author(s):  
Hyun-Soo Moon ◽  
Chong-Hyuk Choi ◽  
Min Jung ◽  
Dae-Young Lee ◽  
Kwang-Sik Eum ◽  
...  
Keyword(s):  
Knee Joint ◽  
Meniscal Tear ◽  
Tibial Slope ◽  
Posterior Horn ◽  
Posterior Tibial Slope ◽  
Control Group ◽  
Posterior Tibial ◽  
Contralateral Knee ◽  
The Mean ◽  
The Relationship

Background: While the medial meniscal posterior horn (MMPH) is reported to bear a considerable portion of overall load on the knee joint, including compressive and shear forces, no study has yet investigated the relationship between the MMPH and posterior tibial slope (PTS), which is a geometric factor associated with the shear force component in the presence of a compressive load in the knee joint. Hypothesis/Purpose: The purpose was to investigate the relationship between the PTS and MMPH tears in patients without ligamentous injury. It was hypothesized that the PTS is greater in patients with MMPH tears as compared with those without. Study Design: Cohort study; Level of evidence, 3. Methods: From March 2015 to December 2018, 159 patients with isolated MMPH tears and 60 patients without any pathologic findings on magnetic resonance imaging (control group) were included in this study. The PTS in the affected and contralateral knees was compared between the groups, which were statistically matched according to baseline characteristics (ie, age, sex, body mass index, radiographic osteoarthritis grade according to the Kellgren-Lawrence scale, and hip-knee-ankle angle) via the inverse probability of treatment weighting method. Furthermore, the MMPH tear group was subdivided according to meniscal tear patterns; these subgroups were then compared with the control group. Results: The mean PTS was significantly greater in the MMPH tear group than in the control group (affected knee: MMPH tear group, 7.0°± 3.4° [mean ± SD]; control group, 5.2°± 2.1°, P < .001; contralateral knee: MMPH tear group, 6.7°± 3.3°; control group, 4.7°± 2.2°, P < .001). The mean PTS in each subgroup also tended to be greater than that in the control group. In the receiver operating characteristic curve analysis, the cutoff point of the PTS discriminating between the MMPH tear and control groups was 6.6° for the affected knee (sensitivity, 55.3%; specificity, 75.0%) and 5.5° for the contralateral knee (sensitivity, 61.0%; specificity, 76.7%). Conclusion: An increased PTS is strongly associated with an increased incidence of MMPH tears and less affected by the meniscal tear patterns.

scholarly journals RELATIONSHIP OF ACL INJURY WITH POSTERIOR TIBIAL SLOPE, INTERCONDYLAR NOTCH WIDTH RATIO, AGE, AND SEX

2019 ◽  
Vol 7 (2) ◽  
pp. 106
Author(s):  
Boby Harul Priono ◽  
Ghuna Arioharjo Utoyo ◽  
Yoyos Dias Ismiarto
Keyword(s):  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Medical Community ◽  
Surgical Reconstruction ◽  
Control Group ◽  
Width Ratio ◽  
P Value ◽  
Posterior Tibial ◽  
Age And Sex

Posterior tibial slope (PTS) has been proposed as a potential risk factor for ACL injury; however, studies that examined this relationship have provided inconclusive and sometimes contradictory results. Further characterization of this relationship may enable the medical community to identify individuals at greater risk for ACL injury and possibly characterize an anatomic target during surgical reconstruction. Medical records of 20 patients who underwent MRI of the knee and athroscopy procedure between August 2016 and March 2017 were reviewed. Patients were separated into 2 groups: a study group of those subjects who had undergone surgery for ACL injury (n =10) and a control group of patients diagnosed without ACL Injury (n = 10). Demographic data were collected, and MRI images from both groups were analyzed using protactor android imaging software to obtain PTS measurements. Data then analyzed using SPSS v20. Data analysis demonstrated that the ACL injury group had significantly greater values for PTS (14.4 SD ± 3.5) compared with controls (10.1 SD ± 2.6). After stepwise elimination of non significant variables, the final t test independent determined that PTS (p value 0.08; p < 0.1) had statistically significant relationships with ACL injury. INW ratio, age, and sex were not demonstrated to be significant predictors of ACL injury in this final model. This study showed a relationship between increased PTS and ACL injury, which corroborates the findings of previously published studies. INW ratio, sex, and age showed no significant relationship with ACL injury.

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