Correlation of tibial parameters like medial, lateral posterior tibial slope and medial plateau depth with ACL injuries: randomized control study

Jagadeesh, Nuthan; Paidipati, Rajashree; Parameshwar, Ambareesh; Shivalingappa, Vishwanath

doi:10.1007/s00590-022-03288-x

Cited by 5 publications

(7 citation statements)

References 18 publications

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“…differences in tibial slope) and dynamic in vivo knee kinematics. Retrospective studies suggest steeper PTS may be a risk factor for ACL injury [15, 16, 20, 33, 38], and steeper PTS may also be associated with greater anterior tibial translation [25, 40] and rotatory laxity [36] after ACL reconstruction (ACL‐R). Recently, Bates et al have demonstrated in a robotic simulation study using 12 cadaveric knees that medial compartment tibial slope angle was moderately correlated with peak internal torque [4].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical imaging studies [6, 13, 15, 16, 20, 33] and computational modeling studies [28] suggest that increased posterior tibial slope (PTS) is associated with increased risk for anterior cruciate ligament (ACL) injury. Biomechanically, cadaveric studies have found steeper PTS is associated with increased anterior tibial translation (ATT) and ACL graft loading [4, 5, 12, 19].…”

Section: Introductionmentioning

confidence: 99%

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Posterior tibial slope and meniscal slope correlate with in vivo tibial internal rotation during running and drop jump

Tanaka

Gale

Nishida

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose The relationship between tibial bony and meniscus anatomy and knee kinematics during in vivo, high-impact activities remains unclear. This study aimed to determine if the posterior tibial slope (PTS) and meniscal slope (MS) are associated with in vivo anterior-posterior translation and internal tibia rotation during running and double-leg drop jumps in healthy knees. Methods Nineteen collegiate athletes performed fast running at 5.0 m/s on an instrumented treadmill and double-leg drop jump from a 60 cm platform while biplane radiographs of the knee were acquired at 150 Hz. Tibiofemoral kinematics were determined using a validated model-based tracking process. Medial and lateral PTS and MS were measured using magnetic resonance imaging (MRI). ResultsIn fast running, more internal tibia rotation was associated with greater PTS (ρ = 0.336, P = 0.039) and MS (ρ = 0.405, P = 0.012) in the medial knee compartment. In the double-leg drop jump, more internal tibia rotation was associated with greater PTS (ρ = 0.431, P = 0.007) and MS (ρ = 0.323, P = 0.005) in the medial knee compartment, as well as a greater PTS in the lateral knee compartment (ρ = 0.445, P = 0.005). Conclusion These indings suggest that the medial and lateral PTS and medial MS are associated with the amount of knee rotation during high-impact activities. These in vivo indings improve our understanding of ACL injury risk by linking bone and meniscus morphology to dynamic kinematics.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Posterior tibial slope and meniscal slope correlate with in vivo tibial internal rotation during running and drop jump

Tanaka

Gale

Nishida

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…However, there is a scarcity of studies examining the anatomical risk factors or biomechanical mechanisms contributing to aACL ruptures leading to ramp lesions. Previous research has delved into the anatomical morphology of the medial knee compartment in isolated ACL ruptures and pure ramp lesions [ 12 , 23 , 24 ]. Therefore, we hypothesized that certain bony variations within the medial tibiofemoral joint might be linked to the development of ramp lesions in conjunction with aACL ruptures.…”

Section: Introductionmentioning

confidence: 99%

Investigation of the anatomic risk factors in acute anterior cruciate ligament ruptures to develop ramp lesions of the medial meniscus by quantitative MRI

Tang,

Luo,

Liu

et al. 2024

Insights Imaging

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Objective To investigate the anatomic risk factors of knee in patients with acute non-contact anterior cruciate ligament (aACL) ruptures to develop ramp lesions. Methods A total of 202 subjects were retrospectively divided into three groups: (1) aACL ruptures combined with ramp lesions group (n = 76); (2) isolated ACL ruptures group (n = 56) and (3) normal controls group (n = 70). Quantitative morphological parameters on MRI were measured including: diameter of medial femoral condyle (MFC), anterior-posterior length and depth of medial tibial plateau (MTP AP length and depth), lateral posterior tibial slope (LPTS) and medial posterior tibial slope (MTPS), asymmetry of LPTS and MPTS (LMPTS), lateral meniscal slope (LMS), and medial meniscal slope (MMS). Results The MTP AP length, MTP AP length/MFC diameter ratio, MTP depth, LPTS and the asymmetry of LMPTS showed significant differences among the three groups (p < 0.001). The risk factors associated with the ramp lesions including a longer MTP AP length (OR 1.17, 95% CI 1.00–1.44, p = 0.044), increased MTP depth (OR 1.91, 95% CI 1.22–3.00, p = 0.005) and lager ratio (OR 1.11, 95% CI 1.01–1.22, p = 0.036). The highest AUC was the MTP AP length/MFC diameter ratio (0.74; 95% CI, 0.66–0.82). The combination model increased higher accuracy (0.80; 95% CI, 0.72–0.88). Conclusion Several bony anatomic characteristics of the knee, especially the morphology of medial tibia plateau, are additional risk factors for aACL ruptures to develop ramp lesions. Critical relevance statement Predictive anatomic risk factors of the knee for patients with acute non-contact anterior cruciate ligament (aACL) ruptures to develop ramp lesions, especially the morphology of medial tibia plateau, are detectable by MRI. Key Points Ramp lesion development can complicate aACL ruptures and requires specific treatment. Longer AP length and increased MTP depth are risk factors for concurrent ramp lesions. Identification of ramp lesions allows for the most appropriate treatment. Graphical Abstract

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“…Various risk factors for an ACL injury have been reported, such as anatomy and kinematics [34]. The relationship between bony morphology and ACL injury has received increasing interest in recent years [6,20,24,27,41]. Misir et al compared 352 men with an injured ACL to 350 uninjured controls and found that notch width/eminence width, medial tibial plateau (MTP) depth, lateral posterior tibial slope (LPTS), lateral condylar anteroposterior distance (LCAP)/tibial proximal anteroposterior 1 3 distance (TPAP), and medial meniscal cartilage angle were associated with an ACL injury [27].…”

Section: Introductionmentioning

confidence: 99%

Bone morphology features associated with knee kinematics may not be predictive of ACL elongation during high‐demand activities

Nukuto,

Gale,

Yamamoto

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Bony morphology has been proposed as a potential risk factor for anterior cruciate ligament (ACL) injury. The relationship between bony morphology, knee kinematics, and ACL elongation during high-demand activities remains unclear. The purpose of this study was to determine if bone morphology features that have been associated with ACL injury risk and knee kinematics are also predictive of ACL elongation during fast running and double-legged drop jump. Methods Nineteen healthy athletes performed fast running and double-legged drop jump within a biplane radiography imaging system. Knee kinematics and ACL elongation were measured bilaterally after using a validated registration process to track bone motion in the radiographs and after identifying ACL attachment sites on magnetic resonance imaging (MRI). Bony morphological features of lateral posterior tibial slope (LPTS), medial tibial plateau (MTP) depth, and lateral femoral condyle anteroposterior width (LCAP)/lateral tibial plateau anteroposterior width (TPAP) were measured on MRI. Relationships between bony morphology and knee kinematics or ACL elongation were identiied using multiple linear regression analysis. ResultsNo associations between bony morphology and knee kinematics or ACL elongation were observed during fast running. During double-legged drop jump, a greater range of tibiofemoral rotation was associated with a steeper LPTS (β = 0.382, p = 0.012) and a deeper MTP depth (β = 0.331, p = 0.028), and a greater range of anterior tibial translation was associated with a shallower MTP depth (β = − 0.352, p = 0.018) and a larger LCAP/ TPAP (β = 0.441, p = 0.005); however, greater ACL elongation was only associated with a deeper MTP depth (β = 0.456, p = 0.006) at toe-of. Conclusion These indings indicate that observed relationships between bony morphology and kinematics should not be extrapolated to imply a relationship also exists between those bone morphology features and ACL elongation during highdemand activities. These new indings deepen our understanding of the relationship between bony morphology and ACL elongation during high-demand activities. This knowledge can help identify high-risk patients for whom additional procedures during ACL reconstruction are most appropriate.

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Correlation of tibial parameters like medial, lateral posterior tibial slope and medial plateau depth with ACL injuries: randomized control study

Cited by 5 publications

References 18 publications

Posterior tibial slope and meniscal slope correlate with in vivo tibial internal rotation during running and drop jump

Posterior tibial slope and meniscal slope correlate with in vivo tibial internal rotation during running and drop jump

Investigation of the anatomic risk factors in acute anterior cruciate ligament ruptures to develop ramp lesions of the medial meniscus by quantitative MRI

Bone morphology features associated with knee kinematics may not be predictive of ACL elongation during high‐demand activities

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