Caudal Slope of the Tibia and Its Relationship to Noncontact Injuries to the Acl

Meister, Keith; Talley, C; Horodyski, Mary Beth; Indelicato, Peter A.; Hartzel, Jonathan; Batts, Joel

doi:10.1097/00005768-199805001-00268

Cited by 52 publications

(89 citation statements)

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“…Some authors have suggested the risk for noncontact ACL injury increases with a greater PTS [4,8,13,35,46]. However, the data are conflicting, perhaps owing to high interindividual tibial plateau variability [19,[23][24][25]46] and imprecise measurement methods on lateral radiographs [26].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors presumed that with greater translation greater ligament loading occurred and placed the ACL at greater risk with an increased PTS [13,17,44]. Thus, noncontact ACL injury was associated with a greater PTS, but published data are contradictory [8,17,35,41,42,44,46,47]. Although there was no ACL tension increase in a biomechanical study [17], computer model data [41,42] support a positive association between ACL tension and a greater PTS.…”

Section: Introductionmentioning

confidence: 99%

“…Although there was no ACL tension increase in a biomechanical study [17], computer model data [41,42] support a positive association between ACL tension and a greater PTS. There is incongruity between five clinical studies [8,21,35,46,47] that concluded a greater risk for noncontact ACL injury in patients with increased PTSs (Table 1). The relationship to injury either was stated only Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

“…Another study reported an association for the PTS in males but it was missing for the female's lateral PTS [21]. One of these studies found no association [35]. Some of the incongruity might result from a mismatch in patient selection and how noncontact ACL injury was defined.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Hudek

Fuchs

Regenfelder

et al. 2011

Clinical Orthopaedics &Amp; Related Research

129

167

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Background The risk of noncontact ACL injury reportedly is increased in patients with a greater posterior tibial slope (PTS), but clinical data are inconsistent. It is unclear whether the medial and lateral PTSs have a different impact on this connection. It also is unknown whether the meniscal slope (MS) is associated with ACL injury. Patients/methods Using MRI, we compared the medial and lateral PTSs and MSs separately in 55 matched pairs of patients with isolated noncontact ACL injuries and a control group.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Hudek

Fuchs

Regenfelder

et al. 2011

Clinical Orthopaedics &Amp; Related Research

129

167

View full text Add to dashboard Cite

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“…This increased angle may increase the risk of the lateral femoral condyle sliding posteriorly down the tibial plateau (gravitational subluxation), which could strain or tear the anterior cruciate ligament with a compressive force. Previous studies 21,22 have shown conflicting results as to whether the posterior tibial slope (referenced off the tibia alone) is increased in subjects incurring noncontact anterior cruciate ligament injury compared with that of control subjects. Yet, it has been shown that during weight-bearing, anterior tibial translation increases as the tibial slope becomes greater.…”

mentioning

confidence: 97%

Tibiofemoral Alignment: Contributing Factors to Noncontact Anterior Cruciate Ligament Injury

Boden

Breit

Sheehan

2009

The Journal of Bone and Joint Surgery-American Volume

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Geometric profile of the tibial plateau cartilage surface is associated with the risk of non‐contact anterior cruciate ligament injury

Beynnon

Vacek

Sturnick

et al. 2013

Journal Orthopaedic Research

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The purpose of this study was to determine if geometry of the articular surfaces of the tibial plateau is associated with non-contact anterior cruciate ligament (ACL) injury. This was a longitudinal cohort study with a nested case-control analysis. Seventyeight subjects who suffered a non-contact ACL tear and a corresponding number of controls matched by age, sex, and sport underwent 3 T MRI of both knees. Surface geometry of the tibial articular cartilage was characterized with polynomial equations and comparisons were made between knees on the same person and between ACL-injured and control subjects. There was no difference in surface geometry between the knees of the control subjects. In contrast, there were significant differences in the surface geometry between the injured and normal knees of the ACL-injured subjects, suggesting that the ACL injury changed the cartilage surface profile. Therefore, comparisons were made between the uninjured knees of the ACL-injured subjects and the corresponding knees of their matched controls and this revealed significant differences in the surface geometry for the medial (p < 0.006) and lateral (p < 0.001) compartments. ACL-injured subjects tended to demonstrate a posterior-inferior directed orientation of the articular surface relative to the long axis of the tibia, while the control subjects were more likely to show a posterior-superior directed orientation. Severe knee injury, such as an anterior cruciate ligament (ACL) disruption, is often immediately disabling and has been associated with the early onset of post-traumatic osteoarthritis regardless of whether surgical or non-surgical treatment is chosen.1,2 This has motivated studies that have focused on identifying the variables associated with increased risk of ACL injury, so that prevention strategies can be developed and those at increased risk can be identified and targeted for intervention. 3During the process of suffering an ACL injury, the geometry of the articular surfaces of the knee is important in controlling the biomechanical response of the tibiofemoral joint and ACL. 4,5 For example, there appears to be a consensus forming in the literature that individuals who are at increased risk of suffering non-contact ACL disruptions have increased posteriorinferior directed slopes of the subchondral bone portion of their tibial plateaus compared to uninjured controls. [6][7][8][9][10][11][12][13][14][15][16] This relationship is important because the magnitude of ACL strain values produced by impulsive loading of the knee during common sportsrelated movements such as jump landings are directly related to the posterior-inferior directed slope of the subchondral bone of the proximal tibia. 4,17,18 Most of what is known about the relationship between the risk of suffering non-contact ACL injury and joint geometry has come from studies of the underlying subchondral bone of the tibia plateau; however, the large inter-segmental forces that are transmitted between the femur and tibia occur across the surface o...

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Caudal Slope of the Tibia and Its Relationship to Noncontact Injuries to the Acl

Cited by 52 publications

References 0 publications

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

Tibiofemoral Alignment: Contributing Factors to Noncontact Anterior Cruciate Ligament Injury

Geometric profile of the tibial plateau cartilage surface is associated with the risk of non‐contact anterior cruciate ligament injury

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