The influence of the steep medial posterior tibial slope on medial meniscus tears in adolescent patients: a retrospective case-control study

Deng, Xiangtian; Hu, Hongzhi; Song, Qingcheng; Zhang, Yiran; Liu, Weijian; Zhu, Lan; Zhang, Yingze

doi:10.1186/s12891-021-04766-9

Cited by 5 publications

(9 citation statements)

References 29 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 In a study by Moon et al 36 examining medial meniscus posterior horn tears, the mean posterior tibial slope was found to be significantly greater in the medial meniscus posterior horn tear group compared with that of the control group, contrasting the results in our study. Deng et al 10 showed a higher posterior tibial slope in a small cohort of adolescent patients with isolated medial meniscal tears than in controls. Both studies, however, used plain radiographic imaging to measure the posterior tibial slope, which has been shown to be a very unreliable method of measurement, prone to produce significant variability in results between studies, especially on short lateral radiographs.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of Size of Posterior Tibial Slope and Medial Tibial Depth in Patients With an Isolated Meniscal Tear Requiring Surgery and Matched Uninjured Controls

Barnett,

Portila,

Sanborn

et al. 2023

Am J Sports Med

View full text Add to dashboard Cite

Background: Meniscal injuries are extremely common. Several anatomic features of the knee, including the tibial plateau morphology, have been shown to influence knee biomechanics and the risk of ligamentous injuries. Little is known, however, how these morphological features influence the risk of isolated meniscal injuries in the anterior cruciate ligament (ACL)–intact knee. Hypothesis: There are differences in the slopes and concavity of the tibial plateau between patients with isolated meniscal tears and matched uninjured controls. Study Design: Cohort study; Level of evidence, 3. Methods: In total, 89 patients with first-instance isolated medial (n = 37) or lateral (n = 52) meniscal injuries requiring surgical treatment (mean age, 16 ± 1 years; 35% female) were matched to 89 controls with uninjured knees and no previous injuries (mean age, 16 ± 2 years; 35% female) based on age and sex. Magnetic resonance imaging scans (preoperative for injured group) were used to measure the coronal slope of the tibial plateau, posterior slope of the medial and lateral tibial plateaus, and maximum depth of the medial tibial plateau. General linear models were used to evaluate the differences in tibial plateau morphology between the knees with and without meniscal injuries, with and without adjustment for age and sex. Results: Compared with matched controls, patients with surgically treated isolated meniscal tears had a smaller lateral tibial slope (by 2.2° [medial meniscal injury] and 1.6° [lateral meniscal injury]; P < .02), a smaller medial tibial slope (by 2.3° [medial meniscal injury] and 2.4° [lateral meniscal injury]; P < .001) and a larger medial tibial depth (by 0.8 mm [medial meniscal injury] and 0.9 mm [lateral meniscal injury]; P < .001). There were no differences in coronal tibial slope between the injured and uninjured groups. There were no differences in quantified anatomic features between the isolated medial and lateral meniscal injury groups. The same trends were observed after adjusting for age and sex. Conclusion: This study suggests that patients with an isolated meniscal tear requiring surgery have a smaller posterior tibial slope and a larger medial tibial depth (more concave medial tibial plateau) than matched uninjured controls. This is contrary to what is known for ACL tears, in which a steeper posterior tibial slope and a shallower medial tibial depth have been associated with an increased risk of ACL tear.

show abstract

Section: Discussioncontrasting

confidence: 99%

Comparison of Size of Posterior Tibial Slope and Medial Tibial Depth in Patients With an Isolated Meniscal Tear Requiring Surgery and Matched Uninjured Controls

Barnett,

Portila,

Sanborn

et al. 2023

Am J Sports Med

View full text Add to dashboard Cite

show abstract

“… Wong et al (2022) utilized the fact that increased LTS leads to worse clinical outcomes (IKDC) in patients after lateral meniscus repair, which seems to indirectly demonstrate that steep LTS is a risk factor for meniscal injury. Deng et al (2021) used X-rays to measure tibial plateau slope and their results identified steep tibial plateau slope as a risk factor for meniscus injury. However, there have also been reports of no association between steep PTS and meniscal injuries ( Beel et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Increased lateral femoral condyle ratio measured by MRI is associated with higher risk of solitary meniscus injury

Yang,

Xing

2024

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Background: Past studies found that an increased lateral femoral condyle ratio is associated with anterior cruciate ligament injuries, but it is not clear if there is a link between MRI-measured lateral femoral condyle ratios and meniscal injuries. MRI provides a more accurate selection of measurement planes. Compared to X-rays, it further reduces data errors due to non-standard positions.Objective: To study the relationship between knee bone morphology and Solitary meniscal injuries by MRI.Methods: A total of 175 patients were included in this retrospective case-control study, including 54 cases of pure medial meniscus injury, 44 cases of pure lateral meniscus injury as the experimental group, and 77 control subjects. MRI images were used to measure the femoral notch width, femoral condylar width, femoral notch width index, lateral femoral condylar ratio (LFCR), posterior tibial slope, medial tibial plateau depth, and meniscus slope. In addition, carefully check for the presence of specific signs such as bone contusions and meniscal extrusions. Comparing the anatomical differences in multiple bone morphologies between the two groups, a stepwise forward multifactorial logistic analysis was used to identify the risk factors for Solitary meniscal injuries. Finally, ROC curves were used to determine the critical values and best predictors of risk factors.Results: MTS, LTS, and LFCR ended up as independent risk factors for meniscus injury. Among all risk factors, LFCR had the largest AUC of 0.781 (0.714–0.848) with a threshold of 72.75%. When combined with MTS (>3.63°), diagnostic performance improved with an AUC of 0.833 (0.774–0.892).Conclusion: Steep medial tibial plateau slope, steep lateral tibial plateau slope angle, and deep posterior lateral femoral condyles on MRI are independent risk factors for meniscal injuries. In patients with knee discomfort with the above imaging findings (X-ray, MRI), we should suspect and carefully evaluate the occurrence of meniscal injuries. It not only provides a theoretical basis to understand the mechanism of meniscus injury but also provides theoretical guidance for the prevention of meniscus injury and the development of intervention measures. Level of evidence III.

show abstract

“…Recently, several studies have investigated the relationship between the posterior tibial slope (PTS) and traumatic knee joint injuries [5, 10, 15, 18, 24, 27]. The PTS is the angle formed by the inclination of the tibial plateau and the longitudinal axis of the tibia, and it can be measured on both tibial plateaus [20].…”

Section: Introductionmentioning

confidence: 99%

Decreased medial posterior tibial slope is associated with an increased risk of posterior cruciate ligament rupture

Zhou

et al. 2023

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

Purpose It remains unclear whether there is an association between posterior cruciate ligament (PCL) rupture and the medial posterior tibial slope (MTS) or lateral posterior tibial slope (LTS). The present case-control study aimed to investigate a possible association between primary PCL rupture and MTS or LTS measured by magnetic resonance imaging (MRI). Methods A retrospective case-control study was conducted. Patients with primary PCL ruptures but not with anterior cruciate ligament injuries, were 1:1 matched by age and sex to a control group with no evidence of knee ligament injuries. Knee MRI was used to measure the MTS and LTS. In addition, the receiver operating characteristic (ROC) analysis was performed to identify an optimal cut-of value of the MTS and/or LTS. Results In total, 46 patients with PCL ruptures (32 males, 14 females) and 46 controls (32 males, 14 females) were included in this study. The MTS was signiicantly lower in the patients with PCL ruptures (3.0° ± 2.2°) than in the control group (5.1° ± 2.3°, p < 0.001). The mean LTS/MTS ratio was signiicantly higher in patients with PCL ruptures (2.6 ± 2.5) than in the control group (1.3 ± 1.3, p = 0.001). However, the LTS was not signiicantly diferent between patients with PCL ruptures and the controls (4.4° ± 2.3° vs. 5.3° ± 2.6°, n.s.). After the MTS was determined to be a signiicant predictor, the ROC analysis was performed. The ROC analysis revealed the most accurate MTS cut-of of < 3.9°, with a sensitivity of 76.1% and a speciicity of 73.9%. Conclusion A decreased MTS and an increased LTS/MTS ratio are associated with an increased risk of primary PCL rupture. People with MTS < 3.9° are particularly at risk for PCL ruptures, and prevention and intervention programs for PCL ruptures should be developed and targeted towards them. Levels of evidence Level III.

show abstract

The influence of the steep medial posterior tibial slope on medial meniscus tears in adolescent patients: a retrospective case-control study

Cited by 5 publications

References 29 publications

Comparison of Size of Posterior Tibial Slope and Medial Tibial Depth in Patients With an Isolated Meniscal Tear Requiring Surgery and Matched Uninjured Controls

Comparison of Size of Posterior Tibial Slope and Medial Tibial Depth in Patients With an Isolated Meniscal Tear Requiring Surgery and Matched Uninjured Controls

Increased lateral femoral condyle ratio measured by MRI is associated with higher risk of solitary meniscus injury

Decreased medial posterior tibial slope is associated with an increased risk of posterior cruciate ligament rupture

Contact Info

Product

Resources

About