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Greater medial tibial slope is associated with increased anterior tibial translation in females with an ACL-deficient knee

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of the study was to determine the correlation between medial tibial slope (MTS) and anterior tibial translation (ATT) in female patients with an ACL-deficient knee. It was hypothesized that female patients with a greater medial tibial slope had an increased anterior tibial translation compared to males.

Methods

MTS and ATT were analysed in 276 patients (138 females and 138 males) with a complete ACL rupture from 2012 to 2016. The mean age was 32 ± 12 years. Previous surgery or additional ligament injury was excluded. CT scan was used for measuring MTS. Meniscal findings were reported. Anterior tibial translation and side to side difference (SSD) were measured by bilateral Telos™ stress radiography with knee flexion of 20°.

Results

There was no significant difference in ATT between females (5.4 ± 3.9) and males (5.8 ± 4.2), nor was there a difference in MTS between females (9.8 ± 2.8) and males (9.8 ± 2.7). A positive correlation was found between MTS and ATT absolute (r = 0.35, p < 0.001) and side to side difference (r = 0.12, p = 0.03). MTS greater or equal to 11° significantly increased the ATT (p < 0.05). For each degree of increase of the MTS, increases in ATT absolute of 0.6 mm and SSD of 0.18 mm were observed. Greater MTS was identified as a risk factor for an increase of ATT in females (r = 0.37, p < 0.001) but not in males (r = − 0.1, n.s). Increases of 1° of MTS increased ATT 0.57 mm in female patients (p < 0.001). MTS was influential in ATT despite the presence (r = 0.28 [0.11, 0.44], p = 0.001) or absence (r = 0.48 [0.35, 0.6], p < 0.001) of meniscal lesions.

Conclusions

Greater medial tibial slope is associated with increased anterior tibial translation in females with ACL-deficient knees compared to males, despite the presence or absence of meniscal lesions. This could be due to a quadriceps/hamstring imbalance in females and the ability of the hamstring muscles to moderate ATT.

Level of evidence

III.

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Abbreviations

ACL:

Anterior cruciate ligament

MTS:

Medial tibial slope

ATT:

Anterior tibial translation

SSD:

Side-to-side difference

IKDC:

International Knee Documentation Committee

PTAA:

Proximal tibial anatomic axis

ICC:

Intra-class correlation

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Funding

No external source of funding was used.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Groupement Hospitalier Nord, Hospices civils de Lyon, Université Claude-Bernard Lyon 1, 103 Grande Rue de la Croix-Rousse, 69004, Lyon, France

    Antoine Schneider, Claudia Arias, Romain Gaillard, Sebastien Lustig & Elvire Servien

  2. Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru

    Claudia Arias

  3. Laboratoire de Biomécanique Et Mécanique Des Chocs (Université Lyon 1/IFSTTAR) LBMC, UMR_T9406, Lyon, France

    Sebastien Lustig

  4. EA 7424, Inter-University Laboratory of Human Movement Science, Lyon, France

    Elvire Servien

  5. Department of Orthopaedics, University of New Mexico, Albuquerque, NM, USA

    Chris Bankhead

Authors
  1. Antoine Schneider
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  2. Claudia Arias
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  3. Chris Bankhead
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  4. Romain Gaillard
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  5. Sebastien Lustig
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  6. Elvire Servien
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Contributions

AS participated in the design of the study, acquisition and interpretation of the data. CAC helped to evaluate the inter-observer reliability and helped to translate the manuscript in English. CB helped to translate the manuscript in English. RG has made substantial contribution to the conception of the study. SL has given final approval of the version to be published. ES has given final approval of the version to be published.

Corresponding author

Correspondence to Claudia Arias.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This study was approved by our institutional review board.

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Patients gave informed consent that data would be published.

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Schneider, A., Arias, C., Bankhead, C. et al. Greater medial tibial slope is associated with increased anterior tibial translation in females with an ACL-deficient knee. Knee Surg Sports Traumatol Arthrosc 28, 1901–1908 (2020). https://doi.org/10.1007/s00167-019-05643-8

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  • DOI: https://doi.org/10.1007/s00167-019-05643-8

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