Shallow Medial Tibial Plateau and Steep Medial and Lateral Tibial Slopes: New Risk Factors for Anterior Cruciate Ligament Injuries

Hashemi, Javad; Chandrashekar, Naveen; Mansouri, Hossein; Gill, Brian J A; Slauterbeck, James R.; Schutt, Robert C.; Dabezies, Eugene J; Beynnon, Bruce D.

doi:10.1177/0363546509349055

Cited by 345 publications

(529 citation statements)

References 29 publications

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“…However, it is unclear why such a difference was not observed among women. A similar inconsistency was reported by Hashemi et al, in which the male's medial PTS was associated with injury but not the female's [21]. They also observed an increased medial tibial plateau depth in conjunction with an increased PTS in patients with noncontact ACL injuries and concluded an increased medial plateau depth as an important risk factor (odds ratio, 3.03), followed by the medial (odds ratio, 1.18) and lateral (odds ratio, 1.17) PTSs [21].…”

Section: Discussionsupporting

confidence: 73%

“…Although some studies relied on the use of the medial PTS, Stijak et al [46] focused on the lateral PTS and reported only a greater lateral PTS promotes injury. However, they also found a greater medial PTS in the control group versus the injured group which contradicts the data of three other studies [8,21,47]. Stijak et al [46] hypothesized that, under normal loading conditions, patients with a greater lateral PTS may have greater internal rotations of the lower leg.…”

Section: Discussionmentioning

confidence: 78%

“…They also observed an increased medial tibial plateau depth in conjunction with an increased PTS in patients with noncontact ACL injuries and concluded an increased medial plateau depth as an important risk factor (odds ratio, 3.03), followed by the medial (odds ratio, 1.18) and lateral (odds ratio, 1.17) PTSs [21]. However, the differences between the injured patients and the control group were 1.5°for both plateaus and 0.9°for the medial plateau depth [21]. We do not share their conclusion.…”

Section: Discussionmentioning

confidence: 94%

“…Another study reported an association for the PTS in males but it was missing for the female's lateral PTS [21]. One of these studies found no association [35].…”

Section: Introductionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Hudek

Fuchs

Regenfelder

et al. 2011

Clinical Orthopaedics &Amp; Related Research

128

167

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Background The risk of noncontact ACL injury reportedly is increased in patients with a greater posterior tibial slope (PTS), but clinical data are inconsistent. It is unclear whether the medial and lateral PTSs have a different impact on this connection. It also is unknown whether the meniscal slope (MS) is associated with ACL injury. Patients/methods Using MRI, we compared the medial and lateral PTSs and MSs separately in 55 matched pairs of patients with isolated noncontact ACL injuries and a control group.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 94%

“…Another study reported an association for the PTS in males but it was missing for the female's lateral PTS [21]. One of these studies found no association [35].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Hudek

Fuchs

Regenfelder

et al. 2011

Clinical Orthopaedics &Amp; Related Research

128

167

View full text Add to dashboard Cite

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Influence of cartilage and menisci on the sagittal slope of the tibial plateaus

et al. 2012

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We analyzed the magnetic resonance studies of the knee in 80 subjects, 45 men and 35 women with a mean age of 38.9 years, who showed no pathological condition of the joint. Using an imaging visualization software, the sagittal longitudinal axis of the tibia was identified. The angle between this axis and a line tangent to the bone profile of the tibial plateau (bone slope) and to the superior border of the menisci (meniscal slope) were calculated. Thickness of anterior and posterior portion of menisci and underlying cartilage were also measured. The bone slope averaged 8° and 7.7° on the medial and lateral sides, respectively. The mean meniscal slope was 4.1° and 3.3° on the medial and lateral sides, respectively, with a significant difference compared with the bone slope. Menisci and underlying cartilage were significantly thicker in their posterior than their anterior portion (7.6 and 5.2 mm, respectively, in the medial compartment; 8.6 and 5.2 mm, respectively, in the lateral compartment). The presence of cartilage and menisci implies a significant decrease in the posterior tibial slope. In the lateral compartment, the greater the bone slope, the larger the difference between bone and meniscal slope, which means that a marked posterior tilt of the lateral tibial plateau is decreased by the cartilage and meniscus. These findings should be taken into account in planning surgical procedures which affect the slope of the articular tibial surface.

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The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

Zhang

Wen

et al. 2020

Clinical Anatomy

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Background Whether the posterior tibial slope (PTS) is associated with the femoral condylar shape has remained unclear. Classical anatomical studies considered the sagittal profiles of femoral condyles to consist of two circles. Recently, an elliptical method was described to simplify the “two circles” model. Our purpose was to analyze the relationship between the PTS and the shape of the sagittal femoral condyle, that is, two circles and two ellipses, using magnetic resonance imaging (MRI) scans. Methods Eighty right knees of healthy subjects were scanned by MRI at full extension. The medial and lateral PTS were measured (mPTS and lPTS). On the distal‐most medial and lateral slices, the femoral condylar articular surfaces were best fitted by circles or ellipses, respectively. The radii of the medial and lateral posterior circles and inferior circles (rm and rl, Rm and Rl, respectively), the semi‐major axes and the semi‐minor axes of the medial and lateral ellipses (am and al, bm and bl, respectively), and the rm/Rm, bm/am, rl/Rl, bl/al ratios were measured and calculated. Results mPTS correlated significantly with the parameters of the medial condyle (all p < .05) and the ratios bm/am and rm/Rm (p = .017 and p = .027, respectively). However, the lPTS did not correlate with the parameters of the lateral condyle (all p > .05) or the ratios bl/al and rl/Rl (p = .461 and p = .241, respectively). Conclusion The mPTS is associated with the sagittal shape of the medial femoral condyle but the lPTS is not. Both two circles and two ellipses are feasible ways to represent the sagittal femoral condylar shape.

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Shallow Medial Tibial Plateau and Steep Medial and Lateral Tibial Slopes: New Risk Factors for Anterior Cruciate Ligament Injuries

Cited by 345 publications

References 29 publications

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

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

Influence of cartilage and menisci on the sagittal slope of the tibial plateaus

The relationship between the posterior tibial slope and the sagittal femoral condylar shape: Two circles and ellipses

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