Increased medial tibial slope in teenage pediatric population with open physes and anterior cruciate ligament injuries

Abstract

PurposeVariations in bony morphology have been associated with anterior cruciate ligament (ACL) injury risk. The primary aim of this study was to compare the tibial slope in the teenage pediatric population with open physes, with and without ACL injury. The secondary aims were to compare the notch width index (NWI) and determine the influence of gender and age on tibial slope and NWI.MethodsThirty-nine teenage pediatric subjects were included in this study, 16 with and 23 without ACL injury. Medial tibial slope and lateral tibial slope and NWI as measured on plain radiographs were compared between the groups using an independent t-test. Comparison of tibial slope and NWI was also performed between male and female subjects. Pearson correlation coefficient between age and tibial slope and NWI was calculated.ResultsThe medial tibial slope averaged 10.2 (±3.9) degrees, the lateral tibial slope 11.5 (±3.9) degrees, and the NWI 0.26. There was a significant difference in medial tibial slope between the ACL-injured (12.1 degrees) subjects and the controls (8.9 degrees) (P = 0.009). There was no significant difference in lateral tibial slope or NWI between the groups. There was no significant difference in the medial tibial slope and lateral tibial slope and NWI between the male and female subjects. Subject age was not correlated with medial tibial slope and lateral tibial slope or NWI.ConclusionThere was an increased medial tibial slope in ACL-injured teenagers with open physes, when compared to a control group of teenager with open physes without ACL injury.

In Vivo Evidence for Tibial Plateau Slope as a Risk Factor for Anterior Cruciate Ligament Injury

“…3 Of the 6 studies that compared LTPS in ACL-injured and uninjured groups as a whole, 1 radiographic study and 1 MRI-based study found no significant difference between injured and uninjured groups. 18,41 …”

“…3,36 For ACL-injured patients, the medial slope ranged from 1.8° ± 3.5° anterior to 12.1° ± 3.3° posterior. 3,41 Figure 4 shows the absolute measurements for MTPS by study. The unweighted mean effect size for the 13 studies was .388, indicating a more posterior MTPS in ACL-injured populations than controls.…”

Is posterior tibial slope associated with noncontact anterior cruciate ligament injury?

“…slope was associated with ACL tear [5,13,40,43,44,46]; on the contrary, others rejected this correlation [4,8,15,17,18,39,42]. Moreover, there exist two metaanalyses came to totally opposite conclusions [48,49].…”

Anterior Cruciate Ligament Injuries Identifiable for Pre-participation Imagiological Analysis: Risk Factors

“…Femoral notch characteristics and tibial plateau slope and/or depth have been proposed as morphologic risk factors possible to identify from standard X-ray evaluation (Vyas et al 2011;Smith et al 2012b;Wordeman et al 2012). Females are more likely than males to have a narrow A-shaped intercondylar notch which has been associated to gender-specific risk factor (Sutton and Bullock 2013).…”

“…Females are more likely than males to have a narrow A-shaped intercondylar notch which has been associated to gender-specific risk factor (Sutton and Bullock 2013). However, notch width index has not been considered a feasible method (Vyas et al 2011). …”