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Posterior tibial slope measurements based on the full-length tibial anatomic axis are significantly increased compared to those based on the half-length tibial anatomic axis

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to compare the difference in posterior tibial slope (PTS) measurements based on the full-length and half-length tibial anatomic axes of the same group of patients. It was hypothesized that the obtained PTS values would be affected by the length of tibia chosen during the measurements.

Methods

Full-length true lateral tibia radiographs were obtained for each patient who underwent anterior cruciate ligament reconstruction (ACLR) in our department. PTS measurements were obtained by measuring the angle between the full-length or half-length tibial anatomic axis and an average of the lateral and medial tibial plateau. The anatomic axis was defined as the center of the tibial diaphysis. The PTS measurements from the full-length and half-length true lateral tibia radiographs were obtained and compared. Additionally, the absolute difference and the relationship between the two PTS measurements were calculated and analyzed.

Results

A total of 200 ACL-injured patients were included in this study. The average PTS values using the anatomic axis were 15.9 ± 3.7° and 14.1 ± 3.7° on full-length and half-length true lateral tibial radiographs. There was a significant difference between the measurements with the full-length and half-length tibial radiographs (P < 0.01). Additionally, 49.5% (n = 99) of patients had ≥ 2.0° differences between the full-length and half-length anatomic axis PTS measurement techniques; meanwhile, a strong and significant linear relationship (r = 0.95; P < 0.001) was identified between the two PTS measurements.

Conclusion

There were significant differences and linear relationships between PTS measurements that measured the anatomic axis from full-length and half-length true lateral tibia radiographs. Therefore, the obtained PTS values were strongly associated with the length of tibia chosen during the measurements. Surgeons should pay more attention to the measurement techniques and the tibial length when considering the role of PTS in ACL injury and ACLR failure. Knowledge of the association is very important for calculating potential closing wedge proximal tibial osteotomies to correct excessive PTS in the setting of ACLR failures.

Level of evidence

IV.

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Availability of data and material

The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

Code availability

Yes.

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Funding

Funding was provided by Capital’s Funds for Health Improvement and Research (CFH2020-1-2071 and CFH2020-2-2075) and the Beijing Talent Work Foundation (2018000021469G227).

Author information

Authors and Affiliations

Authors

Contributions

QN participated in study design, data collection and drafted the manuscript. GS carried out the radiological measurements. ZZ participated in the data collection and statistical analysis. TZ carried out the radiological measurements. YC participated in data collection. HZ conceived of the study, and participated in its design and helped to draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hui Zhang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in this retrospective study were in accordance with the ethical standards of the Beijing Jishuitan hospital, and this study was performed after obtaining approval from our institutional review board (IRB, No. 20160607).

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All patients provided informed consent before participating in this study.

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All patients provided informed consent for publication.

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Ni, QK., Song, GY., Zhang, ZJ. et al. Posterior tibial slope measurements based on the full-length tibial anatomic axis are significantly increased compared to those based on the half-length tibial anatomic axis. Knee Surg Sports Traumatol Arthrosc 30, 1362–1368 (2022). https://doi.org/10.1007/s00167-021-06605-9

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  • DOI: https://doi.org/10.1007/s00167-021-06605-9

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