Sagittal Alignment of the Knee and Its Relationship to Noncontact Anterior Cruciate Ligament Injuries

Terauchi, Masanori; Hatayama, Kazumi; Yanagisawa, Sinya; Saitô, Kenichi; Takagishi, Kenji

doi:10.1177/0363546510393305

Cited by 53 publications

(54 citation statements)

References 25 publications

(40 reference statements)

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“…Simon et al 36 used a slight modification of the method defined by Hashemi et al 11 based on 3-dimensional reconstruction of the tibial geometry and subsequent analysis of the tibial slope. Of the 3 other studies using the exact Hashemi et al 11 methodology, Bisson and Gurske-DePerio 3 and Terauchi et al 39 reported the most similar results. Differences between means in control groups vary by only 0.87°; however, a difference of 0.87° corresponds to nearly the mean difference between control and ACL-injured values reported by Bisson and Gurske-DePerio.…”

Section: Discussionmentioning

confidence: 76%

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

et al. 2012

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Background In vivo studies reporting tibial plateau slope as a risk factor for anterior cruciate ligament (ACL) injury have been published with greatly increasing frequency. Purpose To examine and summarize the in vivo evidence comparing tibial slope in ACL-injured and uninjured populations. Study Design Systematic review and meta-analysis. Methods We reviewed publications in Scopus, SPORTDiscus, CINAHL, and PubMed to identify all studies reporting a measure of tibial plateau slope between ACL-injured groups and controls. A meta-analysis was performed including calculation of effect size and 95% confidence interval as well as 95% confidence intervals for the mean values of the measurement in each study. Results Fourteen studies met our inclusion/exclusion criteria. Five of 6 radiographic studies reporting medial tibial plateau slope (MTPS) demonstrated significant differences between controls and ACL-injured groups, while only 1 of 7 magnetic resonance imaging (MRI) studies reported significant differences between groups. Mean MTPS measurements and standard deviations reported for controls ranged from 2.9° ± 2.8° anterior to 9.5° ± 3° posterior. For ACL-injured patients, MTPS ranged from 1.8° ± 3.5° anterior to 12.1° ± 3.3° posterior. Lateral tibial plateau slope (LTPS) was reported to be significantly greater in ACL-injured groups in all 5 MRI-based studies reporting group comparisons. Mean values for LTPS in controls ranged from 0.3° ± 3.6° anterior slope to 9° ± 4° posterior slope. In ACL-injured groups, mean reported LTPS values ranged from 1.8° ± 3.2° to 11.5° ± 3.54° posterior slope. Conclusion Despite high measures of reliability for the various methods reported in current studies, there is vast disagreement regarding the actual values of the slope that would be considered “at risk.” Reported tibial slope values for control groups vary greatly between studies. In many cases, the study-to-study differences in “normal” tibial slope exceed the difference between controls and ACL-injured patients. The clinical utility of imaging-based measurement methods for the determination of ACL injury risk requires more reliable techniques that demonstrate consistency between studies.

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Section: Discussionmentioning

confidence: 76%

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

et al. 2012

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“…Several clinical studies have pointed to increased posterior slope as a possible risk factor for ACL injury [3,9,27,28]. This has been confirmed through biomechanical testing demonstrating that increasing the posterior slope of the tibial plateau shifts the resting position of the tibia anteriorly and causes a change in the distribution of contact pressures inside the joint [1,11,13,26].…”

Section: Discussionmentioning

confidence: 94%

Effect of tibial slope on the stability of the anterior cruciate ligament–deficient knee

Voos

Suero

Citak

et al. 2011

Knee Surg Sports Traumatol Arthrosc

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“…Most of the ACL injuries are caused by noncontact mechanisms, but only seven studies [4,5,15,17,39,43,44] were constrained to noncontact ACL injury. Furthermore, Anterior tibial cortex 13.8 ± 3.3 13.8 ± 3.5 13.7 ± 2.9 11.6 ± 2.7 11.5 ± 2.6 12 ± 3 the differences in inclusion criteria for the control group showed a larger variation.…”

Section: Discussionmentioning

confidence: 99%

“…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].…”

mentioning

confidence: 99%

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

Zeng

Yang

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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Sagittal Alignment of the Knee and Its Relationship to Noncontact Anterior Cruciate Ligament Injuries

Abstract: There were 2 types of large femoral plateau angles: one had its origin in an increasing tibial posterior slope; the other resulted from hyperextension of the knee. Large posterior tibial slope and hyperextension are both correlated with noncontact ACL injury in women.

Cited by 53 publications

References 25 publications

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

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

Effect of tibial slope on the stability of the anterior cruciate ligament–deficient knee

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

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