Differentiation in Posterior Tibial Slope by Sex, Age, and Race: A Cadaveric Study Utilizing 3-Dimensional Computerized Tomography

Clinger, Bryce N.; Plaster, Scott; Passarelli, Talia; Marshall, N. Justin; Wascher, Daniel C.

doi:10.1177/03635465221108187

Cited by 11 publications

(9 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This condition may show that preoperative evaluation should be made separately for each knee of patients before orthopedic surgeries and the slope for high tibial osteotomies might be different for left and right knees in the same patient. According to our evaluations, MPTS, LPTS, and GPTS means were almost similar for both genders as seen in Figure 5 , which was parallel to the findings of Kumar et al [ 24 ] and Clinger et al [ 25 ] On the other hand, contradictory findings such as lower LPTS values for females have been presented previously by Meier et.al. [ 13 ] Like the study performed by Clinger et al, [ 25 ] in our study, age did not present any significant difference in terms of MPTS, LPTS, and GPTS values.…”

Section: Discussionsupporting

confidence: 91%

CT-based analysis of posterior tibial slope in a Turkish population sample: A retrospective observational study

et al. 2023

View full text Add to dashboard Cite

Posterior tibial slope (PTS) is important for the success of high tibial osteotomy and unicondylar knee arthroplasty applications, as it provides anterior cruciate ligament function. In the literature, different studies have been carried out with various imaging methods to measure PTS in populations of different ethnic origins. In this study, it was aimed to detect PTS in the medial (MPTS) and lateral (LPTS) tibial condyles with computed tomography in a Turkish population sample and to compare the results between age groups (<65, ≥ 65), genders, sides, and literature data. In our sample, 39 left and 33 right knee images of 37 men and 35 women with a mean age of 52.01 ± 21.27 were evaluated. The tibial proximal anatomical axis was determined by the midpoint method. The MPTS and LPTS was evaluated by two different observers according to this axis. Thereby the global PTS (GPTS) was calculated as an arithmetic mean of MPTS and LPTS values. Measurements were repeated 2 weeks after the first measurement and values were analyzed. A significant difference was found between the mean of MPTS, LPTS, and GPTS in the whole population ( P = .002), in men ( P = .02) and in women ( P = .02). On the other hand, there was no significant difference compared according to age, gender, and side by mean of same parameters. In comparison of the results of our Turkish population sample with other studies in the literature, MPTS and LPTS were similar to Chinese ( P = .22, P = .07) and Japanese ( P = .96, P = .67) populations, while different to White Asian ( P < .001, P < .001) and Korean ( P < .001, P < .001) populations. The midpoint method is a safe measurement method in computed tomography-based studies for the evaluation of PTS. Implant designs produces for different populations may not be suitable for the Turkish population. More comprehensive and detailed studies are needed to represent the Turkish population

show abstract

Section: Discussionsupporting

confidence: 91%

CT-based analysis of posterior tibial slope in a Turkish population sample: A retrospective observational study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…It is suspected that the relatively small sample size and inability to match by age and sex in this study limited further evaluation of the role of skeletal maturity and TEF. Interestingly, in a study using computed tomography to measure PTS, Clinger et al 7 found no difference in PTS among sex or age groups. However, the study excluded individuals <18 years old and utilized a different imaging modality and measurement method than that used in our study and the majority of studies concerning PTS, perhaps attributing to these unique findings.…”

Section: Discussionmentioning

confidence: 98%

The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures

et al. 2022

View full text Add to dashboard Cite

Background: Tibial eminence fractures are bony avulsions of the anterior cruciate ligament from its insertion on the intercondylar eminence. Numerous anatomic factors have been associated with anterior cruciate ligament injuries, such as posterior tibial slope, but there are few studies evaluating the association with tibial eminence fracture. Purpose: To compare posterior tibial slope of pediatric patients with and without tibial eminence fractures. We hypothesized that a steeper posterior tibial slope would be associated with tibial eminence fracture. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent surgical treatment of tibial eminence fracture were retrospectively identified between January 2000 and July 2021. Adults aged >20 years and those without adequate imaging were excluded. Controls without gross ligamentous or osseous pathology were identified. Descriptive information and Meyers and McKeever classification were recorded. Posterior tibial slope measurements were obtained by 2 independent orthopaedic surgeons twice, with measurements separated by 3 weeks. Chi-square tests and independent-samples t tests were used to compare posterior tibial slope and patient characteristics. Inter- and intrareviewer variability was determined via the intraclass correlation coefficient. Results: A total of 51 patients with tibial eminence fractures and 57 controls were included. By sex, tibial eminence fractures occurred among 34 male and 17 female patients with a mean age of 10.9 years. The posterior tibial slope among those with tibial eminence fractures (9.7°) was not significantly greater than that of controls (8.8°; P = .07). Male patients with a tibial eminence fracture had significantly steeper slopes compared with controls (10.0° vs 8.4°; P = .006); this difference was not observed between female patients and female controls. Patients with a slope ≥1 SD above the mean (12.0°) had 3.8 times greater odds (95% CI, 1.3-11.6; P = .017) of having a tibial eminence fracture. Male patients with a posterior tibial slope >12° had 5.8 times greater odds (95% CI, 1.1-29.1; P = .034) of having a tibial eminence fracture compared with male controls. Conclusion: Male patients undergoing surgical fixation of a tibial eminence fracture had an increased posterior tibial slope as compared with case-controls. Increased posterior tibial slope may be a risk factor for sustaining a tibial eminence fracture, although the clinical significance of this deserves further investigation.

show abstract

“…A recent cadaveric study using 3-dimensional computed tomography reported that the mean PTS was 8.92°(range, -9.4°to 14.95°) and that nearly 25% of specimens had clinically significant slopes of \6°or .12°. 5 The broadspectrum PTS is known to have a significant effect on in situ forces together with the cruciate ligaments, altering the kinematics of the knee joint by anteriorly or posteriorly shifting the resting position of the tibia. 6,8,22 Although the relationship between the PTS and ACL injuries or graft failure has been actively studied in various groups, 15,17,21,31 little attention has been paid to the relationship between the PTS and PCL injuries or graft failure.…”

Section: Discussionmentioning

confidence: 99%

“…A recent cadaveric study using 3-dimensional computed tomography reported that the mean PTS was 8.92° (range, –9.4° to 14.95°) and that nearly 25% of specimens had clinically significant slopes of <6° or >12°. 5 The broad-spectrum PTS is known to have a significant effect on in situ forces together with the cruciate ligaments, altering the kinematics of the knee joint by anteriorly or posteriorly shifting the resting position of the tibia. 6,8,22…”

Section: Discussionmentioning

confidence: 99%

“…The American Journal of Sports Medicine 2023;51 (5):1194-1201 DOI: 10.1177/03635465231156621 Ó 2023 The Author(s) (MRI), and it is widely used to evaluate the PTS for knee arthroplasty and anterior cruciate ligament (ACL) reconstruction. Yoon et al 31 used the technique in their study, which reported the influence of medial and lateral PTSs on the clinical outcomes of ACL reconstruction.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effect of Posterior Tibial Slopes on Graft Survival Rates at 10 Years After Primary Single-Bundle Posterior Cruciate Ligament Reconstruction

et al. 2023

View full text Add to dashboard Cite

Background: Recent biomechanical studies have reported that stress on the posterior cruciate ligament (PCL) graft increases as the posterior tibial slope (PTS) decreases (flattened) in knees with single-bundle (SB) and double-bundle PCL reconstruction. Clinical studies of SB PCL reconstruction have shown that a flattened PTS is associated with a lesser reduction in posterior tibial translation. There is no long-term study on the clinical outcomes and graft survival rates of SB PCL reconstruction based on the medial and lateral PTSs measured on magnetic resonance imaging. Hypothesis: Flattened medial and lateral PTSs are associated with poor clinical outcomes and graft survival rates at a minimum 10-year follow-up after SB PCL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: In this cohort study, we retrospectively reviewed 46 patients (mean age, 28.8 ± 9.9 years) who underwent primary SB PCL reconstruction between 2000 and 2009. They were followed up for a minimum of 10 years. The medial and lateral PTSs were measured on preoperative magnetic resonance imaging. As a previous study reported that a steeper medial or lateral PTS showed a higher risk of anterior tibial translation at thresholds of 5.6° and 3.8°, respectively, the patients were divided into 2 groups based on the cutoff values of both the medial (≤5.6° vs >5.6°) and lateral (≤3.8° vs >3.8°) PTSs. Clinical scores (International Knee Documentation Committee subjective score, Lysholm score, and Tegner activity score), radiological outcomes (side-to-side difference [SSD] on stress radiography and osteoarthritis progression), and graft survival rates were compared between the groups at the last follow-up. Results: All clinical scores and the progression of osteoarthritis demonstrated no significant difference between the 2 subgroups of both the medial and lateral PTS groups. The mean SSD on stress radiography after SB PCL reconstruction was significantly greater in patients with a medial PTS ≤5.6° than in patients with a medial PTS >5.6° (8.4 ± 3.9 vs 5.1 ± 2.9 mm, respectively; P = .030), while the lateral PTS subgroups after SB PCL reconstruction demonstrated no significant difference. The minimum 10-year graft survival rate was significantly lower in patients with a medial PTS ≤5.6° (68.4% vs 92.6%, respectively; P = .029) and a lateral PTS ≤3.8° (50.0% vs 91.7%, respectively; P = .001). Conclusion: A flattened medial PTS (≤5.6°) was associated with an increased SSD on stress radiography, and both flattened medial (≤5.6°) and lateral (≤3.8°) PTSs resulted in lower graft survival rates at a minimum 10-year follow-up after primary SB PCL reconstruction.

show abstract

Differentiation in Posterior Tibial Slope by Sex, Age, and Race: A Cadaveric Study Utilizing 3-Dimensional Computerized Tomography

Cited by 11 publications

References 33 publications

CT-based analysis of posterior tibial slope in a Turkish population sample: A retrospective observational study

CT-based analysis of posterior tibial slope in a Turkish population sample: A retrospective observational study

The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures

Effect of Posterior Tibial Slopes on Graft Survival Rates at 10 Years After Primary Single-Bundle Posterior Cruciate Ligament Reconstruction

Contact Info

Product

Resources

About