Tibial slope in the posterolateral quadrant with and without ACL injury.
Anterior cruciate ligament injury
Knee instability
Posterolateral tibial impression
Standard value tibial slope
Tibial slope
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
20
10
2021
accepted:
30
11
2021
pubmed:
30
12
2021
medline:
28
10
2022
entrez:
29
12
2021
Statut:
ppublish
Résumé
An increased tibial slope is a risk factor for rupture of the anterior cruciate ligament. In addition, a tibial bone bruise or posterior lateral impression associated with slope changes also poses chronic ligamentous instability of the knee joint associated with an anterior cruciate ligament (ACL) injury. In the majority of cases, the slope is measured in one plane X-ray in the lateral view. However, this does not sufficient represent the complex anatomy of the tibial plateau and especially for the posterolateral quadrant. Normal values from a "healthy" population are necessary to understand if stability of the knee joint is negatively affected by an increasing slope in the posterolateral area. Until now there are no data about the physiological slope in the posterolateral quadrant of the tibial plateau. In 116 MRI scans of patients without ligamentous lesions and 116 MRI scans with an ACL rupture, tibial slope was retrospectively determined using the method described by Hudek et al. Measurements were made in the postero-latero-lateral (PLL) and postero-latero-central (PLC) segments using the 10-segment classification. In both segments, the osseous as well as the cartilaginous slope was measured. Measurements were performed by two independent surgeons. In the group without ligamentous injury the mean bony PLL slope was 5.8° ± 4.8° and the cartilaginous PLL slope was 6.7° ± 4.8°. In the PLC segment the mean bony slope was 6.6° ± 5.0° and the cartilaginous slope was 9.4° ± 5.7°. In the cohort with ACL rupture, the bony and cartilaginous slope in both PLL and PCL were significantly higher (P < 0.001) than in the group without ACL injury (bony PLL 9.8° ± 4.8°, cartilage PLL 10.4° ± 4.7°, bony PLC 10.3° ± 4.8°, cartilage PLL 12.8° ± 4.3°). Measurements were performed independently by two experienced surgeons. There were good inter- (CI 87-98.7%) and good intraobserver (CI 85.8-99.6%) reliability. The bony and the cartilaginous slope in the posterolateral quadrant of the tibial plateau are different but not independent. Patients with an anterior cruciate ligament injury have a significantly steeper slope in the posterolateral quadrant compared to a healthy group. Our data indicate that this anatomic feature might be a risk factor for a primary ACL injury which has not been described yet. III.
Identifiants
pubmed: 34964068
doi: 10.1007/s00402-021-04298-w
pii: 10.1007/s00402-021-04298-w
pmc: PMC9596559
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3917-3925Informations de copyright
© 2021. The Author(s).
Références
Kim SY, Spritzer CE, Utturkar GM, Toth AP, Garrett WE, DeFrate LE (2015) Knee kinematics during noncontact anterior cruciate ligament injury as determined from bone bruise location. Am J Sports Med 43:2515–2521. https://doi.org/10.1177/0363546515594446
doi: 10.1177/0363546515594446
pubmed: 26264770
pmcid: 4681280
Horstmann H, Petri M, Tegtbur U, Felmet G, Krettek C, Jagodzinski M (2021) Quadriceps and hamstring tendon autografts in ACL reconstruction yield comparably good results in a prospective, randomized controlled trial. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-03862-8
doi: 10.1007/s00402-021-03862-8
pubmed: 34633513
pmcid: 9296410
Korthaus A, Warncke M, Pagenstert G, Krause M, Frosch KH, Kolb JP (2021) Lateral femoral notch sign and posterolateral tibial plateau fractures and their associated injuries in the setting of an anterior cruciate ligament rupture. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-021-04105-6
doi: 10.1007/s00402-021-04105-6
pubmed: 34964068
pmcid: 9217893
Bernholt DL, DePhillipo NN, Crawford MD, Aman ZS, Grantham WJ, LaPrade RF (2020) Incidence of displaced posterolateral tibial plateau and lateral femoral condyle impaction fractures in the setting of primary anterior cruciate ligament tear. Am J Sports Med 48:545–553. https://doi.org/10.1177/0363546519895239
doi: 10.1177/0363546519895239
pubmed: 31917606
Marouane H, Shirazi-Adl A, Hashemi J (2015) Quantification of the role of tibial posterior slope in knee joint mechanics and ACL force in simulated gait. J Biomech 48:1899–1905. https://doi.org/10.1016/j.jbiomech.2015.04.017
doi: 10.1016/j.jbiomech.2015.04.017
pubmed: 25920895
Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD (2004) Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 32:376–382. https://doi.org/10.1177/0363546503258880
doi: 10.1177/0363546503258880
pubmed: 14977661
Feucht MJ, Mauro CS, Brucker PU, Imhoff AB, Hinterwimmer S (2013) The role of the tibial slope in sustaining and treating anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc 21:134–145. https://doi.org/10.1007/s00167-012-1941-6
doi: 10.1007/s00167-012-1941-6
pubmed: 22395233
Butler DL, Noyes FR, Grood ES (1980) Ligamentous restraints to anterior–posterior drawer in the human knee. A biomechanical study. J Bone Jt Surg Am 62:259–270
doi: 10.2106/00004623-198062020-00013
Imhoff FB, Mehl J, Comer BJ, Obopilwe E, Cote MP, Feucht MJ et al (2019) Slope-reducing tibial osteotomy decreases ACL-graft forces and anterior tibial translation under axial load. Knee Surg Sports Traumatol Arthrosc 27:3381–3389. https://doi.org/10.1007/s00167-019-05360-2
doi: 10.1007/s00167-019-05360-2
pubmed: 30687890
Grassi A, Macchiarola L, Urrizola Barrientos F, Zicaro JP, Costa Paz M, Adravanti P et al (2019) Steep posterior tibial slope, anterior tibial subluxation, deep posterior lateral femoral condyle, and meniscal deficiency are common findings in multiple anterior cruciate ligament failures: an MRI case–control study. Am J Sports Med 47:285–295. https://doi.org/10.1177/0363546518823544
doi: 10.1177/0363546518823544
pubmed: 30657705
Schneider A, Arias C, Bankhead C, Gaillard R, Lustig S, Servien E (2020) Greater medial tibial slope is associated with increased anterior tibial translation in females with an ACL-deficient knee. Knee Surg Sports Traumatol Arthrosc 28:1901–1908. https://doi.org/10.1007/s00167-019-05643-8
doi: 10.1007/s00167-019-05643-8
pubmed: 31375877
Herbort M (2020) The “Bankart knee”: biomechanical consequences of a posterolateral tibia plateau impression fracture as concomitant injury of ACL rupture. ACL study group, Kitzbuehel. Kitzbuehel
Kawashima I, Tsukahara T, Sakai T, Kawai R, Ishizuka S, Hiraiwa H et al (2021) Delayed anterior cruciate ligament reconstruction increases the incidence of medial meniscal bucket handle tears and medial compartment chondral injuries in patients aged 40 years and older. Arch Orthop Trauma Surg 141:971–975. https://doi.org/10.1007/s00402-020-03745-4
doi: 10.1007/s00402-020-03745-4
pubmed: 33426607
Akoto R, Alm L, Drenck TC, Frings J, Krause M, Frosch K-H (2020) Slope-correction osteotomy with lateral extra-articular tenodesis and revision anterior cruciate ligament reconstruction is highly effective in treating high-grade anterior knee laxity. Am J Sports Med 48:3478–3485. https://doi.org/10.1177/0363546520966327
doi: 10.1177/0363546520966327
pubmed: 33135908
pmcid: 7705640
Alm L, Drenck TC, Frosch KH, Akoto R (2020) Lateral extra-articular tenodesis in patients with revision anterior cruciate ligament (ACL) reconstruction and high-grade anterior knee instability. Knee 27:1451–1457. https://doi.org/10.1016/j.knee.2020.06.005
doi: 10.1016/j.knee.2020.06.005
pubmed: 33010761
Kolbe R, Schmidt-Hebbel A, Forkel P, Pogorzelski J, Imhoff AB, Feucht MJ (2019) Steep lateral tibial slope and lateral-to-medial slope asymmetry are risk factors for concomitant posterolateral meniscus root tears in anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc 27:2585–2591. https://doi.org/10.1007/s00167-018-5279-6
doi: 10.1007/s00167-018-5279-6
pubmed: 30390134
Sabzevari S, Rahnemai-Azar AA, Shaikh HS, Arner JW, Irrgang JJ, Fu FH (2017) Increased lateral tibial posterior slope is related to tibial tunnel widening after primary ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 25:3906–3913. https://doi.org/10.1007/s00167-017-4435-8
doi: 10.1007/s00167-017-4435-8
pubmed: 28260200
Ackermann C, Frings J, Alm L, Frosch KH (2019) Arthroscopic controlled closed reduction and percutaneous fixation of posterolateral tibia plateau impression fractures. Arthrosc Tech 8:e867–e874. https://doi.org/10.1016/j.eats.2019.04.001
doi: 10.1016/j.eats.2019.04.001
pubmed: 31700782
pmcid: 6823802
Amerinatanzi A, Summers RK, Ahmadi K, Goel VK, Hewett TE, Nyman E (2017) Automated measurement of patient-specific tibial slopes from MRI. Bioengineering (Basel). https://doi.org/10.3390/bioengineering4030069
doi: 10.3390/bioengineering4030069
Krause M, Preiss A, Müller G, Madert J, Fehske K, Neumann MV et al (2016) Intra-articular tibial plateau fracture characteristics according to the “Ten segment classification.” Injury 47:2551–2557. https://doi.org/10.1016/j.injury.2016.09.014
doi: 10.1016/j.injury.2016.09.014
pubmed: 27616003
Menzdorf L, Drenck T, Akoto R, Hartel M, Krause M, Guttowski D et al (2020) Clinical results after surgical treatment of posterolateral tibial plateau fractures (“apple bite fracture”) in combination with ACL injuries. Eur J Trauma Emerg Surg 46:1239–1248. https://doi.org/10.1007/s00068-020-01509-8
doi: 10.1007/s00068-020-01509-8
pubmed: 32980883
Hudek R, Schmutz S, Regenfelder F, Fuchs B, Koch PP (2009) Novel measurement technique of the tibial slope on conventional MRI. Clin Orthop Relat Res 467:2066–2072. https://doi.org/10.1007/s11999-009-0711-3
doi: 10.1007/s11999-009-0711-3
pubmed: 19190973
pmcid: 2706341
Lipps DB, Wilson AM, Ashton-Miller JA, Wojtys EM (2012) Evaluation of different methods for measuring lateral tibial slope using magnetic resonance imaging. Am J Sports Med 40:2731–2736. https://doi.org/10.1177/0363546512461749
doi: 10.1177/0363546512461749
pubmed: 23075804
pmcid: 4091991
Fleiss JL, Levin B, Paik MC (1981) The measurement of interrater agreement. Stat Methods Rates Proportions 2:22–23
Utzschneider S, Goettinger M, Weber P, Horng A, Glaser C, Jansson V et al (2011) Development and validation of a new method for the radiologic measurement of the tibial slope. Knee Surg Sports Traumatol Arthrosc 19:1643–1648. https://doi.org/10.1007/s00167-011-1414-3
doi: 10.1007/s00167-011-1414-3
pubmed: 21298254
Wordeman SC, Quatman CE, Kaeding CC, Hewett TE (2012) In vivo evidence for tibial plateau slope as a risk factor for anterior cruciate ligament injury: a systematic review and meta-analysis. Am J Sports Med 40:1673–1681. https://doi.org/10.1177/0363546512442307
doi: 10.1177/0363546512442307
pubmed: 22539537
pmcid: 4168892
Stijak L, Herzog RF, Schai P (2008) Is there an influence of the tibial slope of the lateral condyle on the ACL lesion? Knee Surg Sports Traumatol Arthrosc 16:112–117. https://doi.org/10.1007/s00167-007-0438-1
doi: 10.1007/s00167-007-0438-1
pubmed: 18239948
Jenny JY, Rapp E, Kehr P (1997) Proximal tibial meniscal slope: a comparison with the bone slope. Rev Chir Orthop Reparatrice Appar Mot 83:435–438. https://doi.org/10.1016/S0924-9338(14)77645-X
doi: 10.1016/S0924-9338(14)77645-X
pubmed: 9452795
Cinotti G, Sessa P, Ragusa G, Ripani FR, Postacchini R, Masciangelo R et al (2013) Influence of cartilage and menisci on the sagittal slope of the tibial plateaus. Clin Anat 26:883–892. https://doi.org/10.1002/ca.22118
doi: 10.1002/ca.22118
pubmed: 22730027
Elmansori A, Lording T, Dumas R, Elmajri K, Neyret P, Lustig S (2017) Proximal tibial bony and meniscal slopes are higher in ACL injured subjects than controls: a comparative MRI study. Knee Surg Sports Traumatol Arthrosc 25:1598–1605. https://doi.org/10.1007/s00167-017-4447-4
doi: 10.1007/s00167-017-4447-4
pubmed: 28213703
Khan N, Shepel M, Leswick DA, Obaid H (2014) Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee? Skelet Radiol 43:437–441. https://doi.org/10.1007/s00256-013-1800-7
doi: 10.1007/s00256-013-1800-7
Cai G, Jiang M, Cicuttini F, Jones G (2019) Association of age, sex and BMI with the rate of change in tibial cartilage volume: a 10.7-year longitudinal cohort study. Arthritis Res Ther 21:273. https://doi.org/10.1186/s13075-019-2063-z
doi: 10.1186/s13075-019-2063-z
pubmed: 31818318
pmcid: 6902563
Vyas S, van Eck CF, Vyas N, Fu FH, Otsuka NY (2011) Increased medial tibial slope in teenage pediatric population with open physes and anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc 19:372–377. https://doi.org/10.1007/s00167-010-1216-z
doi: 10.1007/s00167-010-1216-z
pubmed: 20676607
Hohmann E, Bryant A, Reaburn P, Tetsworth K (2011) Is there a correlation between posterior tibial slope and non-contact anterior cruciate ligament injuries? Knee Surg Sports Traumatol Arthrosc 19:109–114. https://doi.org/10.1007/s00167-011-1547-4
doi: 10.1007/s00167-011-1547-4
Winkler PW, Godshaw BM, Karlsson J, Getgood AMJ, Musahl V (2021) Posterior tibial slope: the fingerprint of the tibial bone. Knee Surg Sports Traumatol Arthrosc 29:1687–1689. https://doi.org/10.1007/s00167-021-06578-9
doi: 10.1007/s00167-021-06578-9
pubmed: 33903924