Anatomical variation of posterior slope of tibial plateau in adult Eastern Indian population

Abstract

Background:Upper surface of the proximal tibial end, tibial plateau, has a slope directed posteroinferiorly relative to the long axis of the middle of the shaft. It has important consideration in surgeries such as knee arthroplasty, high tibial osteotomy, and medical imaging of the knee joint. The aim of the present study was to estimate the tibial plateau angle (TPA) by plain radiograph in the adult Eastern Indian population as during literature review, we were unable to find any study, except one (without specific reference axis), on this variable among the Indian population.Materials and Methods:A sample was taken from adult patients attending the outpatient department of orthopedics of the institute with minor knee problems. Measurement of the TPA was done in the true lateral radiographs of the knee joints of the selected subjects by a standardized method.Results:TPA varied widely from 6° to 24°, with the mean ± standard deviation value 13.6° ±3.5°. Student's unpaired t-test revealed no significant difference of TPA between left and right knees, both in male (P = 0.748) and female (P = 0.917) separately and in the entire study population irrespective of gender (P = 0.768). Comparison of TPA between male (13.3° ± 3.3°) and female (13.9° ± 3.4°) by Student's unpaired t-test showed no sexual dimorphism (P = 0.248). There were poor correlations of TPA with age and body mass index.Conclusion:The present study described the variations of the TPA in the adult Eastern Indian population (range 6°–24°, mean ± SD 13.6° ± 3.5°, no laterality, no sexual dimorphism, poor correlation with age and BMI). Knowledge of this study could be used in different orthopedic surgeries and imaging technique in or around the knee joint.

The effect of gender, age, and body mass index on the medial and lateral posterior tibial slopes: a magnetic resonance imaging study

“…Cinotti et al [ 20 ] and Han et al [ 22 ] also reported no gender difference in medial and lateral PTS angles in Italian and South Korean participants. This is consistent with several radiographic studies conducted in different ethnic groups [ 2 , 12 , 26 ]. In contrast, Hashemi et al [ 15 ] found that the medial and lateral PTS angles were greater in women compared to men, potentially rendering them more susceptible to developing an ACL injury and ATT [ 5 – 7 ].…”

“…A steeper PTS increases the likelihood of sustaining an ATT [ 7 , 30 ]. Higher BMI was linked to an increased risk of ACL tear in the presence of a steeper lateral PTS [ 31 ], because a steeper PTS facilitates the tibia in translating anteriorly, which results in overtightening of the ACL, one of the main structures responsible for knee stability [ 2 , 3 ]. It is possible that the extra load on the knee joint from obesity may increase the wear and tear process of the cartilage and bone surfaces of the knee, a primary weight-bearing joint, leading to alteration of the proximal tibia and subsequent modification of the PTS.…”

“…The angle formed between the tibial longitudinal axis and the posterior inclination of the proximal surface of the tibia is defined as the posterior tibial slope (PTS) [ 1 ]. PTS is crucial in knee joint stability and in maintaining the natural movement of the knee, particularly knee flexion [ 2 , 3 ]. An alteration in the PTS angle changes the mechanical axis of the natural knee, which is essential in maintaining normal knee kinematics [ 3 , 4 ].…”

Variability of the Posterior Tibial Slope in Saudis: A Radiographic Study

“…In the present study, there was no significant difference in PTS between males and females (P >0.05). Likewise, Katchy et al [ 13 ] and Medda et al [ 23 ] found no sexual dimorphism among Nigerian and Indian subsets, respectively. MRI of the knee is the gold standard modality by which medial and lateral tibial plateaus can be assessed separately [ 19 ].…”

“…Differences in the PTS among ethnic groups have already been reported [ 13 - 15 , 20 , 23 ]. Table 6 presents PTS angles measurements among different populations, using a similar reference axis (ATC).…”