2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper

 

4 To 6° Is The Target Posterior Tibial Slope After Tibial Deflection Osteotomy According To The Knee Static Anterior Tibial Translation

Michael J. Dan, Mbbs, PhD, MSc(res), FRACS(oath), Merewether AUSTRALIA
Nicolas Cance, MD, Lyon, Rhône-Alpes FRANCE
Tomas Pineda, MD, Santiago CHILE
Guillaume Demey, MD, Lyon, Rhône Alpes FRANCE
David H. Dejour, MD, Lyon FRANCE

Ortho Clinic, Lyon, FRANCE

FDA Status Not Applicable

Summary

Our previously held target of 2° to 5° Posterior Tibial Slope(PTS) overcorrected the Static Anterior Tibial Translation(SATT). Therefore, considering as a goal 0 to 5 mm of SATT, we suggest a new target of 4° to 6° PTS.

Abstract

Introduction

To correlate changes in posterior tibial slope (PTS) with changes to static anterior tibial translation (SATT) with tibial deflexion osteotomy (TDO), in order to define a target postoperative tibial slope based on postoperative SATT.

Methods

We reviewed a consecutive series of primary and revision anterior cruciate ligament reconstruction with TDO between 2011 and 2022. PTS and SATT were measured pre- and postoperatively directly from the radiographs by 2 independent reviewers. Regression analysis was performed to investigate the relationship of postoperative SATT with PTS, gender, graft type, and meniscal injury.

Results

A total of 48 patients were included in this study. The mean (SD) decrease in PTS and SATT was 8.85° (3.03°; 12.5° to 3.59°, P < .01), and 7.93 mm (3.68; 5.37 to -2.55 mm, P < .01), respectively. Upon univariate analysis, the only factor influencing ΔSATT was ΔPTS. For each 1° of decreased slope, SATT was reduced by 0.46 mm. The mean (SD) PTS for a negative SATT was 2.81° (2.78°) compared to 5.09° (3.25°) for a SATT of 0 to 5mm (P < .01).

Conclusions

This study reports weightbearing SATT in association with PTS after TDO. The TDO successfully reduced the SATT, with the change in PTS the only significant predictor of postoperative SATT. Based on our results, our previously held target of 2° to 5° PTS overcorrected the SATT. Therefore, considering as a goal 0 to 5 mm of SATT, we suggest a new target of 4° to 6° PTS.