2023 ISAKOS Biennial Congress ePoster
Posterior Tibial Slope is a Dynamic Entity: An Anthropomorphic Study
Sumit Banerjee, MS (Orth), MCh(Orth), Jodhpur, Rajasthan INDIA
Meghal Goyal, MS, Agra, Uttar pradesh INDIA
Pawan Kumar Garg, MD, Jodhpur, Rajasthan INDIA
Nitesh Gahlot, MBBS, MS Ortho, DNB Ortho, FACS, MNAMS, Jodhpur, Rajasthan INDIA
Abhay Elhence, MS, MCH, Jodhpur, Rajasthan INDIA
All India Institute of Medical Sciences, Jodhpur, Jodhpur , Rajasthan, INDIA
FDA Status Cleared
Summary
PTS is a dynamic entity that varies with age and needs to be accounted for while analysing risk factors and treatment planning in different age groups; also increase in MPTS and LPTS can be used individually and in combination as a predictive risk factor for ACL injury.
ePosters will be available shortly before Congress
Abstract
Background
ACL injury is a common presentation for individuals in the orthopaedics outpatient department. A better understanding of the association between posterior tibial slope(PTS) and ACL injury might help identify the high-risk population and consequently take corresponding preventive measures. There is a paucity in literature regarding the age-related changes in PTS. Therefore, this study was planned to help us identify the trend in the variation of the PTS with age and the role of the PTS in incidence of ACL injury with advancing age in a South Asian country.
Objectives: To study the variation of the posterior tibial slope with age and to determine its association with anterior cruciate ligament injury.
Methods
Data for 312 patients (423 knees) were included, out of which there were 189 males (232 knees) and 123 females (191 knees). Anteroposterior and true lateral view radiographs (of the knee joints of the selected subjects were taken. Medial Posterior tibial slope (MPTS) and Lateral Posterior tibial slope (LPTS) were measured in the true lateral view radiographs of patients using the Radiant DICOM software version 2021.1 (Medixant, Poland). Patients were then grouped into various age groups- up to third decade (18-30 years), fourth decade (31-40 years), fifth decade (41-50 years), sixth decade (51-60 years), seventh decade (61-70 years) and >70 years. Student t-tests and curve fitting were used to analyse data using SPSS software version 25 ( IBM inc., USA)
Results
The MPTS varied between 5.30°-21.60° with a mean value of 12.437°±2.79° while the LPTS varied between 3.00° and 18.10° with a mean value of 9.527°±2.65°. The curve fitting for MPTS demonstrated a trend of first increasing and then decreasing with aging while for LPTS demonstrated a trend of decreasing with aging. There was no significant gender-based variation of PTS in different age groups in our study. MPTS variation was associated with ACL injury in age-group 18 to 40 years (p<0.05) and LPTS variation was associated with ACL injury in age group 18 to 30 years (p=0.01). The values of the slopes (MPTS and LPTS) were higher in subjects with ACL Injury.
Conclusion
Posterior tibial slope is a dynamic entity and its value is different across age groups. Lateral radiograph of knee is feasible and cheap enabling large sample sizes for assessing PTS in a population. MPTS follows a trend of first increasing and then decreasing with advancing age while LPTS follows a trend of decreasing with increasing age. There was no sexual dimorphism in MPTS and LPTS in different age groups. These trends need to be taken into account while analysing risk factors, treatment planning and coupling surgical techniques in different age groups. Variation in both MPTS and LPTS were associated with existence of ACL injury and can be utilised individually and in combination as a predictive risk factor for ACL injury.