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Anatomical variation of posterior slope of tibial plateau in adult Eastern Indian population

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Abstract

Background:

Upper surface of the proximal tibial end, tibial plateau, has a slope directed posteroinferiorly relative to the long axis of the middle of the shaft. It has important consideration in surgeries such as knee arthroplasty, high tibial osteotomy, and medical imaging of the knee joint. The aim of the present study was to estimate the tibial plateau angle (TPA) by plain radiograph in the adult Eastern Indian population as during literature review, we were unable to fnd any study, except one (without specifc reference axis), on this variable among the Indian population.

Materials and Methods:

A sample was taken from adult patients attending the outpatient department of orthopedics of the institute with minor knee problems. Measurement of the TPA was done in the true lateral radiographs of the knee joints of the selected subjects by a standardized method.

Results:

TPA varied widely from 6° to 24°, with the mean ± standard deviation value 13.6° ±3.5°. Student’s unpaired t-test revealed no signifcant difference of TPA between left and right knees, both in male (P = 0.748) and female (P = 0.917) separately and in the entire study population irrespective of gender (P = 0.768). Comparison of TPA between male (13.3° ± 3.3°) and female (13.9° ± 3.4°) by Student’s unpaired t-test showed no sexual dimorphism (P = 0.248). There were poor correlations of TPA with age and body mass index. Conclusion: The present study described the variations of the TPA in the adult Eastern Indian population (range 6°–24°, mean ± SD 13.6° ± 3.5°, no laterality, no sexual dimorphism, poor correlation with age and BMI). Knowledge of this study could be used in different orthopedic surgeries and imaging technique in or around the knee joint.

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References

  1. Didia BC, Jaja BN. Posterior slope of tibial plateau in adult Nigerian subjects. Int J Morphol 2009;27:201–4.

    Article  Google Scholar 

  2. Khattak MJ, Umer M, Davis ET, Habib M, Ahmed M. Lower-limb alignment and posterior tibial slope in Pakistanis: A radiographic study. J Orthop Surg (Hong Kong) 2010;18:22–5.

    Article  Google Scholar 

  3. Moore TM, Harvey JP Jr. Roentgenographic measurement of tibial-plateau depression due to fracture. J Bone Joint Surg Am 1974;56:155–60.

    Article  CAS  PubMed  Google Scholar 

  4. Titze A. Die variationen der neigung der schienbeinkopfgelenkflache. (The variations of the inclination of the tibial upper articular surface) Zeitschrift f. Orthop 1951;LXXX: 436.

  5. Kate BR, Robert SL. Some observations on the upper end of the tibia in squatters. J Anat 1965;99:137–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Hashemi J, Chandrashekar N, Gill B, Beynnon BD, Slauterbeck JR, Schutt RC Jr., et al. The geometry of the tibial plateau and its influence on the biomechanics of the tibiofemoral joint. J Bone Joint Surg Am 2008;90:2724–34.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Vyas S, van Eck CF, Vyas N, Fu FH, Otsuka NY. Increased medial tibial slope in teenage pediatric population with open physes and anterior cruciate ligament injuries. Knee Surg Sports Traumatol Arthrosc 2011;19:372–7.

    Article  PubMed  Google Scholar 

  8. Yoga R, Sivapathasundaram N, Suresh C. Posterior slope of the tibia plateau in Malaysian patients undergoing total knee replacement. Malays Orthop J 2009;3:78–80.

    Article  Google Scholar 

  9. 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;32:376–82.

    Article  PubMed  Google Scholar 

  10. Inoue S, Nagamine R, Miura H, Urabe K, Matsuda S, Sakaki K, et al. Anteroposterior weight-bearing radiography of the knee with both knees in semiflexion, using new equipment. J Orthop Sci 2001;6:475–80.

    Article  CAS  PubMed  Google Scholar 

  11. Moroni A, Pezzuto V, Pompili M, Zinghi G. Proximal osteotomy of the tibia for the treatment of genu recurvatum in adults. J Bone Joint Surg Am 1992;74:577–86.

    Article  CAS  PubMed  Google Scholar 

  12. Naudie DD, Amendola A, Fowler PJ. Opening wedge high tibial osteotomy for symptomatic hyperextension-varus thrust. Am J Sports Med 2004;32:60–70.

    Article  PubMed  Google Scholar 

  13. Hernigou P, Medevielle D, Debeyre J, Goutallier D. Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year followup study. J Bone Joint Surg Am 1987;69:332–54.

    CAS  Google Scholar 

  14. Hernigou P, Deschamps G. Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 2004;86-A: 506–11.

    Article  Google Scholar 

  15. Kim KH, Bin SI, Kim JM. The correlation between posterior tibial slope and maximal angle of flexion after total knee arthroplasty. Knee Surg Relat Res 2012;24:158–63.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rohr WL Jr., Hugerford DS. Primary total knee arthroplasty. In: Chapman MW, Madison M, editors. Operative Orthopedics. 2nd ed., Vol. 3. Philadelphia: JB Lippincott Company; 1993. p. 1968.

  17. Walker PS, Garg A. Range of motion in total knee arthroplasty. A computer analysis. Clin Orthop Relat Res 1991;262:227–35.

    Google Scholar 

  18. Chiu KY, Zhang SD, Zhang GH. Posterior slope of tibial plateau in Chinese. J Arthroplasty 2000;15:224–7.

    Article  CAS  PubMed  Google Scholar 

  19. Jiang CC, Yip KM, Liu TK. Posterior slope angle of the medial tibial plateau. J Formos Med Assoc 1994;93:509–12.

    CAS  PubMed  Google Scholar 

  20. Bisson LJ, Gurske-DePerio J. Axial and sagittal knee geometry as a risk factor for noncontact anterior cruciate ligament tear: A case-control study. Arthroscopy 2010;26:901–6.

    Article  PubMed  Google Scholar 

  21. Brandon ML, Haynes PT, Bonamo JR, Flynn MI, Barrett GR, Sherman MF. The association between posterior-inferior tibial slope and anterior cruciate ligament insufficiency. Arthroscopy 2006;22:894–9.

    Article  PubMed  Google Scholar 

  22. Dejour H, Bonnin M. Tibial translation after anterior cruciate ligament rupture. Two radiological tests compared. J Bone Joint Surg Br 1994;76:745–9.

    Article  CAS  PubMed  Google Scholar 

  23. Shelburne KB, Kim HJ, Sterett WI, Pandy MG. Effect of posterior tibial slope on knee biomechanics during functional activity. J Orthop Res 2011;29:223–31.

    Article  PubMed  Google Scholar 

  24. Simon RA, Everhart JS, Nagaraja HN, Chaudhari AM. A case-control study of anterior cruciate ligament volume, tibial plateau slopes and intercondylar notch dimensions in ACL-injured knees. J Biomech 2010;43:1702–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Todd MS, Lalliss S, Garcia E, DeBerardino TM, Cameron KL. The relationship between posterior tibial slope and anterior cruciate ligament injuries. Am J Sports Med 2010;38:63–7.

    Article  PubMed  Google Scholar 

  26. Greenspan A. Orthopedic Radiology. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2000. p. 229.

  27. Brazier J, Migaud H, Gougeon F, Cotten A, Fontaine C, Duquennoy A. Evaluation of methods for radiographic measurement of the tibial slope. A study of 83 healthy knees. Rev Chir Orthop Reparatrice Appar Mot 1996;82:195–200.

    CAS  PubMed  Google Scholar 

  28. Yoo JH, Chang CB, Shin KS, Seong SC, Kim TK. Anatomical references to assess the posterior tibial slope in total knee arthroplasty: A comparison of 5 anatomical axes. J Arthroplasty 2008;23:586–92.

    Article  PubMed  Google Scholar 

  29. Genin P, Weill G, Julliard R. The tibial slope. Proposal for a measurement method. J Radiol 1993;74:27–33.

    CAS  PubMed  Google Scholar 

  30. Yue B, Varadarajan KM, Ai S, Tang T, Rubash HE, Li G. Gender differences in the knees of Chinese population. Knee Surg Sports Traumatol Arthrosc 2011;19:80–8.

    Article  PubMed  Google Scholar 

  31. Swain MS, Henschke N, Kamper SJ, Downie AS, Koes BW, Maher CG. Accuracy of clinical tests in the diagnosis of anterior cruciate ligament injury: A systematic review. Chiropr Man Therap 2014;22:25.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Shyamalendu Medda.

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Medda, S., Kundu, R., Sengupta, S. et al. Anatomical variation of posterior slope of tibial plateau in adult Eastern Indian population. IJOO 51, 69–74 (2017). https://doi.org/10.4103/0019-5413.197545

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  • DOI: https://doi.org/10.4103/0019-5413.197545

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