Is there an influence of the tibial slope of the lateral condyle on the ACL lesion?

Abstract

This study examines the effect of the tibial slope on the anterior cruciate ligament lesion (separately on the lateral and medial tibial condyle). The study consisted of 33 matched pairs of patients divided into two groups: an examined group with a diagnosed ACL lesion, and a control group with diagnosed patellofemoral pain. The patients were matched on the basis of four attributes: age, sex, type of lesion (whether it was profession-related), and whether the lesion was left- or right-sided. Measurements were carried out by radiography and MRI. In the examined group, the lateral tibial plateau was significantly greater than in the control group (P < 0.001), and the medial tibial plateau had lower tibial slope values than the control group; however, the difference was not statistically significant (P = 0.066). In both groups, the difference between the slopes on the lateral and medial plateaus was statistically significant (P < 0.001). In relation to ACL intact patients, population with ACL rupture have greater tibial slope of the lateral condyle. The greater tibial slope of the lateral tibial plateau may be the factor that leads to the injury of the anterior cruciate ligament. Compared to the medial plateau, the population with ACL rupture have a greater tibial slope on the lateral plateau, while the population of the intact ACL have greater tibial slope on the medial plateau. The tibial slope of the medial and lateral condyle should be compared separately because the values obtained from the two sets of data were different, revealing apparently opposing effects on the ACL lesion.

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

“…A sample size of 54 individuals for both groups was calculated to detect a 1.5°difference with a power of 0.94 at an a-error of 0.05. The targeted primary outcome variable was set to 1.5°b ecause PTS differences reported in the literature range from 0.9°-3.4° [8,46,47]. The typical errors for interobserver and intraobserver variability related to the method used herein are 1.4°and 1.2°, respectively [23].…”

“…for the lateral plateau [46] or only for females [47]. Another study reported an association for the PTS in males but it was missing for the female's lateral PTS [21].…”

“…Some authors presumed that with greater translation greater ligament loading occurred and placed the ACL at greater risk with an increased PTS [13,17,44]. Thus, noncontact ACL injury was associated with a greater PTS, but published data are contradictory [8,17,35,41,42,44,46,47]. Although there was no ACL tension increase in a biomechanical study [17], computer model data [41,42] support a positive association between ACL tension and a greater PTS.…”

“…Although there was no ACL tension increase in a biomechanical study [17], computer model data [41,42] support a positive association between ACL tension and a greater PTS. There is incongruity between five clinical studies [8,21,35,46,47] that concluded a greater risk for noncontact ACL injury in patients with increased PTSs (Table 1). The relationship to injury either was stated only Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

“…All of the referenced data were assessed using different methods. The medial and lateral PTSs in an individual are not necessarily similar, and the variability among individuals is high [19,25,26,46]. The greater the variability of a parameter within a population, the broader will be the range of the observed data.…”