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>

scholarly journals Measurement of Posterior Tibial Slope in Turkish Population Groups with Magnetic Resonance İmaging

2020 ◽  
Author(s):  
Musab Ümeyir Karakanlı ◽  
Ferdanur Deniz ◽  
İlkin Celilov ◽  
Ömer Sofulu ◽  
Fatih Küçükdurmaz
Keyword(s):  
Magnetic Resonance ◽  
Tibial Slope ◽  
Turkish Population ◽  
Magnetic Resonance Images ◽  
Posterior Tibial Slope ◽  
Slice Thickness ◽  
Posterior Tibial ◽  
Significant Difference ◽  
History Of ◽  
The Mean

Abstract Background The posterior tibial slope (PTS) has great importance on the balance and the stability of the knee and has to be taken into account during the reconstruction and replacement procedure. However, the anthropometric measurements are not universal and show population-based variations. The purpose of this study is to find features of PTS in the Turkish population in regards to the medial and lateral compartment. Methods Magnetic resonance images (MRIs) were retrieved from the Picture Archiving and Communication System (PACS). Subjects from 25 to 45 years old were included from the MRIs taken between July 2015 to July 2017. Any MRI with radiological signs of osteoarthritis, chondral and meniscus (grade 3 & 4) lesions was excluded as well as a deformity in the lower extremity, patients with a history of fracture and/or history of knee surgery. The measurements were made using T1-weighted coronal and sagittal MRI planes with a slice thickness of 4 mm. The PTS of the medial, lateral plateau were recorded with gender and age of the subjects. Non-parametric Spearman's Correlation tests and Student T tests were used to calculate the relationship between medial-lateral PTS and ages and also to evaluate PTS differences between genders. Results Two-hundred thirty-two subjects (122 female, 110 male) were included in the study. The mean medial and lateral PTS were 7.7°±1.3° and 7.5°±1.3° respectively, and there was a significant correlation (p < 0.001). However, no significant difference was found in the mean medial PTS (p = 0.45) and lateral PTS (p = 0.73) between genders and matched age groups. Conclusions Our results showed that there is no gender-based variation in the Turkish population. Although we do not make a systematic comparison, the measurements of PTS in the Turkish population were different from other populations.

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 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

Preoperative laxity in ACL-deficient knees increases with posterior tibial slope and medial meniscal tears

2018 ◽  
Vol 27 (2) ◽  
pp. 564-572 ◽  
Author(s):  
David Dejour ◽  
Marco Pungitore ◽  
Jeremy Valluy ◽  
Luca Nover ◽  
Mo Saffarini ◽  
...  
Keyword(s):  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Meniscal Tears ◽  
Posterior Tibial ◽  
Acl Deficient

scholarly journals Ángulo de pendiente tibial posterior “Slope” en prótesis total de rodilla. Diferencias entre alineación Intra o Extramedular y su repercusión sobre el rango de movilidad postoperatorio.

2019 ◽  
pp. 143-148
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Slope Angle ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Slope ◽  
Posterior Tibial ◽  
Total Knee ◽  
The Mean ◽  
Posterior Slope Angle

Introduction: The aim of this work was to compare the posterior tibial slope of the tibial component after performing a total knee arthroplasty, as an intramedullary or extramedullary guide was used during the surgical technique, as well as comparing the range of mobility obtained according to the Instrumentation used. Material and methods: We conducted a descriptive, retrospective, observational study of a series of 57 patients operated in our Center during 2012 and 2013, with the same model of total knee arthroplasty (Sigma PS® DePuy), divided into two homogeneous groups in terms of age, sex, degree of osteoarthritis evolution, the first with patients operated by extramedullary guidance and the second by intramedullary guidance. A radiographic study was performed, measuring the posterior slope angle in the sagittal plane. The range of mobility achieved after arthroplasty and implant survival was studied. Results: Together, in both groups, measurements of the posterior slope angle were made, which was 4.35º preoperative average. In groups, the mean postoperative posterior fall angle was 4.04 ° in the patients who underwent an EM guide, while those who underwent an IM guide the mean was 1.76 °; the differences being statistically significant. The range of mobility in the ATRs operated by intramedullary guidance was 102.7º on average (range 80-125º), while in the group where the extramedullary guide was used, it was 104.3º (range 80-130º) no these differences being statistically significant. Regarding the survival of the implant, during the study period two cases of patients undergoing surgery for the replacement of prostheses were found, both of which belonged to the “Extramedullary guide” group. Conclusion: The posterior drop angle, for the same PS prosthesis model, was statistically different according to the guide used, being within the 3-7º range in the group where the extramedullary guide was used; but despite these differences, no impact on the range of mobility was observed. Currently, it is recommended to restore the patient's posterior tibial slope, and in cases with a slope greater than 10º use a PS ATR.

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 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.

The Medial Tibial Plateau Can Be Used as a Direct Anatomical Reference for the Posterior Tibial Slope in Medial Unicompartmental Knee Arthroplasty

2021 ◽  
Author(s):  
Shigeshi Mori ◽  
Masao Akagi ◽  
Akihiro Moritake ◽  
Ichiro Tsukamoto ◽  
Kotaro Yamagishi ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Plateau ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
The Mean ◽  
Ct Data ◽  
The Individual

AbstractThere has been no consensus about how to determine the individual posterior tibial slope (PTS) intraoperatively. The purpose of this study was to investigate whether the tibial plateau could be used as a reference for reproducing individual PTS during medial unicompartmental knee arthroplasty (UKA). Preoperative computed tomography (CT) data from 48 lower limbs for medial UKA were imported into a three-dimensional planning software. Digitally reconstructed radiographs were created from the CT data as the lateral knee plain radiographs and the radiographic PTS angle was measured. Then, the PTS angles on the medial one-quarter and the center of the MTP (¼ and ½ MTP, respectively), and that on the medial tibial eminence (TE) were measured on the sagittal multiplanar reconstruction image. Finally, 20 lateral knee radiographs with an arthroscopic probe placed on the ¼ and the ½ MTP were obtained intraoperatively, and the angle between the axis of the probe and the tangent line of the plateau was measured. The mean radiographic PTS angle was 7.9 ± 3.0 degrees (range: 1.7–13.6 degrees). The mean PTS angles on the ¼ MTP, the ½ MTP, and the TE were 8.1 ± 3.0 degrees (1.2–13.4 degrees), 9.1 ± 3.0 degrees (1.4–14.7 degrees), and 9.9 ± 3.1 degrees (3.1–15.7 degrees), respectively. The PTS angles on the ¼ MTP and the ½ MTP were strongly correlated with the radiographic PTS angle (r =0.87 and 0.80, respectively, p < 0.001). A statistically significant difference was observed between the mean angle of the radiographic PTS and the PTS on the TE (p < 0.01). The mean angle between the axis of the probe and the tangent line of the tibial plateau was −0.4 ± 0.9 degrees (−2.3–1.3 degrees) on the ¼ MTP and −0.1 ± 0.7 degrees (−1.5–1.2 degrees) on the ½ MTP, respectively. An area from the medial one-quarter to the center of the MTP could be used as an anatomical reference for the individual PTS.

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