Measurement of Posterior Tibial Slope Using Magnetic Resonance Imaging

Document Type: RESEARCH PAPER

Authors

1 Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Taleghani hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Posterior tibial slope (PTS) is an important factor in the knee joint biomechanics and one of the bone features, which leads to knee joint stability. Posterior tibial slope affects flexion gap, knee joint stability and posterior femoral rollback that are related to wide range of knee motion. During high tibial osteotomy and total knee arthroplasty (TKA) surgery, proper retaining the mechanical and anatomical axis is important. The aim of this study was to evaluate the value of posterior tibial slope in medial and lateral compartments of tibial plateau and to assess the relationship among the slope with age, gender and other variables of tibial plateau surface.
Materials and methods: This descriptive study was conducted on 132 healthy knees (80 males and 52 females) with a mean age of 38.26±11.45 (20-60 years) at a medical center in Mashhad, Iran. All patients required to MRI admitted for knee pain with uncertain clinical history and physical examination that were reported healthy at knee examination were enrolled in the study.
Results: The mean posterior tibial slope was 7.78±2.48 degrees in the medial compartment and 6.85±2.24 degrees in lateral compartment. No significant correlation was found between age and gender with posterior tibial slope (P≥0.05), but there was significant relationship among PTS with mediolateral width, plateau area and medial plateau.
Conclusions: Comparison of different studies revealed that the PTS value in our study is different from other communities, which genetic and racial factors can be involved in these differences. The results of our study are useful to PTS reconstruction in surgeries.

Keywords

Main Subjects


1. Heidari Nik H. The study of body abnormalities in
student’s boy in Komijan city. Available at: URL: http://
Komijanpazhoheshblogfacom/post-4aspx/; 2007.
2. Moreland JR, Bassett LW, Hanker GJ. Radiographic
analysis of the axial alignment of the lower extremity.
J Bone Joint Surg Am. 1987; 69(5):745-9.
3. Hsu RW, Himeno S, Coventry MB, Chao EY. Normal
axial alignment of the lower extremity and loadbearing
distribution at the knee. Clin Orthop Relat
Res. 1990; 255(1):21527-.
4. Dejour H, Bonnin M. Tibial translation after anterior
cruciate ligament rupture. Two radiological tests
compared. J Bone Joint Surg Br. 1994; 76(5):745-9.
5. Shoemaker SC, Markolf KL, Finerman G. In vitro
stability of the implanted total condylar prosthesis.
Effects of joint load and of sectioning the posterior
cruciate ligament. J Bone Joint Surg Am. 1982;
64(8):1201-13.
6. Genin P, Weill G, Julliard R. The tibial slope. Proposal for
a measurement method. J Radiol. 1993; 74(1):27-33.
7. Brandon ML, Haynes PT, Bonamo JR, Flynn MI, Barrett
GR, Sherman MF. The association between posteriorinferior
tibial slope and anterior cruciate ligament
insufficiency. Arthroscopy. 2006; 22(8):894-9.
8. Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD.
Effects of increasing tibial slope on the biomechanics
of the knee. Am J Sports Med. 2004; 32(2):376-82.
9. Bae DK, Yoon KH, Song SJ, Noh JH, Kim MH. The change
of the posterior tibial slope after cruciate retaining
total knee arthroplasty. J Korean Orthop Assoc. 2008;
43(2):207-12.
10. Martineau PA, Fening SD, Miniaci A. Anterior opening
wedge high tibial osteotomy: the effect of increasing
posterior tibial slope on ligament strain. Can J Surg.
2010; 53(4):261-7.
11. Campbell W, Canale ST, Beaty JH. Campbell’s operative
orthopaedics. 11th ed. Philadelphia: Mosby, Elsevier;
2008.
12. Insall JN. Surgical techniques and instrumentation in
total knee arthroplasty. Surg Knee. 1993; 43(2):739-
804.
13. Stöckl B, Nogler M, Rosiek R, Fischer M, Krismer M,
Kessler O. Navigation improves accuracy of rotational
alignment in total knee arthroplasty. Clin Orthop
Relat Res. 2004; 426(1):1806-.
14. Noyes FR, Goebel SX, West J. Opening wedge tibial
osteotomy the 3-triangle method to correct axial
alignment and tibial slope. Am J Sports Med. 2005;
33(3):378-87.
15. Seo JG, Moon YW, Kim JH. Influence of posterior
tibial slope on stability after total knee arthroplasty.
J Korean Knee Soc. 2007; 19(2):218-24.
16. Moore TM, Harvey JP Jr. Roentgenographic

measurement of tibial-plateau depression due to
fracture. J Bone Joint Surg Am. 1974; 56(1):155-60.
17. Matsuda S, Miura H, Nagamine R, Urabe K, Ikenoue T,
Okazaki K, et al. Posterior tibial slope in the normal
and varus knee. Am J Knee Surg. 1998; 12(3):165-8.
18. Chiu KY, Zhang SD, Zhang GH. Posterior slope of tibial
plateau in Chinese. J Arthroplasty. 2000; 15(2):224-7.
19. Hosseinzadeh HR, Zandi R, Kazemi SM, Qoreishi SM,
Shahi S, Safdari F, et al. Measurement of posterior
tibial slope (a cross-sectional study in Tehran). Iran J
Orthop Surg. 2011; 9(2):61-4.
20. Mohamad Qoreishi M, Syavash Hemmati M, Ali Sina
Shahi M, Mehrnoush Hassas Yeganeh M, Kazemi
SM. Measurement of posterior tibial slope (a crosssectional
study in Tehran). JBS J. 2015; 2(1):10-5.
21. Mahmodi SM, Zahraii M. An introduction and study of
the knee joint structural parameters and their impact
on degenerative joint disease. Med J Iran Hospital
Dubai. 1998; 1:40-1.
22. Shahla A, Charesaz S. Hamze zade A. Influence of
anatomical parameters in knee osteoarthritis. Urmia
Med J. 2007; 18(1):402-6.
23. Fukubayashi T, Kurosawa H. The contact area and
pressure distributionpattern of the knee: a study of
normal and osteoarthrotic knee joints. Acta Orthop
Scand. 1980; 51(6):871-9.
24. Dehghan M, Bahmani MT. Anatomical parameters
associated with osteoarthritis of the knee joint.
Armaghane Danesh. 2014; 19(5):462-9.
25. Garg A, Walker PS. Prediction of total knee motion
using a three-dimensional computer-graphics model.
J Biomech. 1990; 23(1):45-58.
26. Hernigou P, Deschamps G. Posterior slope of the tibial
implant and the outcome of unicompartmental knee
arthroplasty. J Bone Joint Surg Am. 2004; 86(3):506-11.
27. Hofmann AA, Bachus KN, Wyatt RW. Effect of the tibial
cut on subsidence following total knee arthroplasty.
Clin Orthop Relat Res. 1991; 269(1):63-9.
28. Callaghan JJ, O’Rourke MR, Goetz DD, Schmalzried TP,
Campbell PA, Johnston RC. Tibial post impingement
in posterior-stabilized total knee arthroplasty. Clin
Orthop Relat Res. 2002; 404(1):83-8.
29. Kaper BP, Bourne RB, Rorabeck CH, MacDonald
SJ. Patellar infera after high tibial osteotomy. J
Arthroplasty. 2001; 16(2):168-73.
30. Hohmann E, Bryant A, Imhoff AB. The effect of
closed wedge high tibial osteotomy on tibial slope:
a radiographic study. Knee Surg Sports Traumatol
Arthrosc. 2006; 14(5):454-9.
31.Çullu E, Aydoğdu S, Alparslan B, Sur H. Tibial slope
changes following dome-type high tibial osteotomy.
Knee Surg Sports Traumatol Arthrosc. 2005;
13(1):38-43.