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Steep lateral tibial slope and lateral-to-medial slope asymmetry are risk factors for concomitant posterolateral meniscus root tears in anterior cruciate ligament injuries

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare sagittal and coronal tibial slopes between anterior cruciate ligament (ACL) injured subjects with and without posterolateral meniscus root tear (PLRT).

Methods

A chart review was conducted to identify patients with isolated ACL tears and patients with an associated PLRT. Patients with other concomitant injuries and patients who underwent surgery > 6 months after the injury were excluded. Magnetic resonance image data were used to compare the medial and lateral sagittal tibial slope (MTS and LTS), lateral-to-medial slope asymmetry (LTS–MTS), and coronal slope of the tibial plateau between both groups. Mean LTS and standard deviation (SD) of the control group were calculated, and a value of > mean + 1 SD was considered an abnormal LTS. Interobserver reproducibility was assessed by calculating interclass correlation coefficients (ICCs) of measurements independently obtained by two reviewers.

Results

Fifty-nine patients met the in- and exclusion criteria. Thirty nine (66%) had an isolated ACL tear and 20 (34%) had an associated PLRT. Interrater ICCs for LTS, MTS, and coronal slope were 0.930, 0.884 and 0.825, respectively, representing good to excellent interobserver reproducibility. Patients with a PLRT had significantly steeper LTS (8.0 ± 3.2 vs. 4.0 ± 2.0; p < 0.001) and significantly greater difference of LTS–MTS (3.7 ± 2.9 vs. − 0.6 ± 2.0; p < 0.001). Furthermore, patients with abnormal LTS were significantly overrepresented among patients with PLRT (70% vs. 18%; p < 0.001). No significant difference between both groups was found for MTS and coronal slope.

Conclusion

A steep lateral tibial slope and lateral-to-medial slope asymmetry are risk factors for concomitant PLRT in ACL-injured subjects.

Level of evidence

IV, retrospective cohort study.

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Authors and Affiliations

  1. Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany

    Rainer Kolbe, Andrés Schmidt-Hebbel, Philipp Forkel, Jonas Pogorzelski, Andreas B. Imhoff & Matthias J. Feucht

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  1. Rainer Kolbe
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  2. Andrés Schmidt-Hebbel
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  3. Philipp Forkel
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  4. Jonas Pogorzelski
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  5. Andreas B. Imhoff
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  6. Matthias J. Feucht
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Correspondence to Matthias J. Feucht.

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Ethical approval

This study was approved by the Institutional Review Board (IRB) of the Technical University of Munich (Ethical approval No. 351/18 S).

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Kolbe, R., Schmidt-Hebbel, A., Forkel, P. et al. Steep lateral tibial slope and lateral-to-medial slope asymmetry are risk factors for concomitant posterolateral meniscus root tears in anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc 27, 2585–2591 (2019). https://doi.org/10.1007/s00167-018-5279-6

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  • DOI: https://doi.org/10.1007/s00167-018-5279-6

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