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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2018

09.09.2017 | Knee

High tibial slope correlates with increased posterior tibial translation in healthy knees

verfasst von: Imke Schatka, Andreas Weiler, Tobias M. Jung, Thula C. Walter, Clemens Gwinner

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 9/2018

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Abstract

Purpose

Notwithstanding the importance of the tibial slope (TS) for anterior tibial translation, little information is available regarding the implications on posterior laxity, particularly in healthy subjects. It was hypothesized that increased TS is associated with decreased posterior tibial translation (PTT) in healthy knees.

Methods

A total of 124 stress radiographs of healthy knees were enrolled in this study. Tibial slope and the posterior tibial translation were evaluated using a Telos device with a 150-N force at 90° of knee flexion. Two blinded observers reviewed independently on two different occasions.

Results

One hundred and twenty-four patients [35 females and 89 males; 41 (range 18–75) years] were enrolled in this study, with a mean PTT of 2.8 mm (±1.9 mm; range 0–8 mm) and a mean TS of 8.6° (±2.6°; range 1°–14°). Pearson correlation showed a significant correlation between the PTT and TS in the overall patient cohort (P < 0.0001) with r = 0.76 and R 2 = 0.58. There was no statistical difference between female and male patients regarding the PTT or the TS. Subgrouping of the patient cohort (four groups with n = 31) according to their TS (groups I < 7°; II = 7°–8.5°; III = 9°–10.5°; IV ≥ 11°) revealed significant differences between each subgroup, respectively. Furthermore, there was a weak but significant correlation between age and PTT (P = 0.004, r = 0.26).

Conclusion

In addition to the substantial variance in tibial slope and posterior laxity among healthy knees, high tibial slope significantly correlates with increased posterior tibial translation. Increasing age is further associated with a greater magnitude of posterior tibial translation. Consequently, knowledge of the tibial slope facilitates simple estimation of posterior knee laxity, which is mandatory for PCL reconstruction and knee arthroplasty.
Literatur
1.
Zurück zum Zitat Ahmad R, Patel A et al (2016) Posterior tibial slope: effect on, and interaction with, knee kinematics. JBJS Rev 4:31–36CrossRef Ahmad R, Patel A et al (2016) Posterior tibial slope: effect on, and interaction with, knee kinematics. JBJS Rev 4:31–36CrossRef
2.
Zurück zum Zitat Arima J, Whiteside LA et al (1998) Effect of partial release of the posterior cruciate ligament in total knee arthroplasty. Clin Orthop Relat Res 353:194–202CrossRef Arima J, Whiteside LA et al (1998) Effect of partial release of the posterior cruciate ligament in total knee arthroplasty. Clin Orthop Relat Res 353:194–202CrossRef
3.
Zurück zum Zitat Barrett GR, Savoie FH (1991) Operative management of acute PCL injuries with associated pathology: long-term results. Orthopedics 14:687–692PubMed Barrett GR, Savoie FH (1991) Operative management of acute PCL injuries with associated pathology: long-term results. Orthopedics 14:687–692PubMed
4.
Zurück zum Zitat Bellemans J, Robijns F et al (2005) The influence of tibial slope on maximal flexion after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 13:193–196CrossRefPubMed Bellemans J, Robijns F et al (2005) The influence of tibial slope on maximal flexion after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 13:193–196CrossRefPubMed
5.
Zurück zum Zitat Beynnon BD, Fleming BC et al (2002) Chronic anterior cruciate ligament deficiency is associated with increased anterior translation of the tibia during the transition from non-weightbearing to weightbearing. J Orthop Res 20:332–337CrossRefPubMed Beynnon BD, Fleming BC et al (2002) Chronic anterior cruciate ligament deficiency is associated with increased anterior translation of the tibia during the transition from non-weightbearing to weightbearing. J Orthop Res 20:332–337CrossRefPubMed
6.
Zurück zum Zitat Cantin O, Magnusson RA et al (2015) The role of high tibial osteotomy in the treatment of knee laxity: a comprehensive review. Knee Surg Sports Traumatol Arthrosc 23:3026–3037CrossRefPubMed Cantin O, Magnusson RA et al (2015) The role of high tibial osteotomy in the treatment of knee laxity: a comprehensive review. Knee Surg Sports Traumatol Arthrosc 23:3026–3037CrossRefPubMed
7.
Zurück zum Zitat Chatellard R, Sauleau V et al (2013) Medial unicompartmental knee arthroplasty: does tibial component position influence clinical outcomes and arthroplasty survival? Orthop Traumatol Surg Res 99:S219–S225CrossRefPubMed Chatellard R, Sauleau V et al (2013) Medial unicompartmental knee arthroplasty: does tibial component position influence clinical outcomes and arthroplasty survival? Orthop Traumatol Surg Res 99:S219–S225CrossRefPubMed
8.
Zurück zum Zitat Dejour H, Bonnin M (1994) Tibial translation after anterior cruciate ligament rupture. Two radiological tests compared. J Bone Joint Surg Br 76:745–749CrossRefPubMed Dejour H, Bonnin M (1994) Tibial translation after anterior cruciate ligament rupture. Two radiological tests compared. J Bone Joint Surg Br 76:745–749CrossRefPubMed
9.
Zurück zum Zitat D’Lima DD, Patil S et al (2007) An ABJS best paper: dynamic intraoperative ligament balancing for total knee arthroplasty. Clin Orthop Relat Res 463:208–212PubMed D’Lima DD, Patil S et al (2007) An ABJS best paper: dynamic intraoperative ligament balancing for total knee arthroplasty. Clin Orthop Relat Res 463:208–212PubMed
10.
Zurück zum Zitat Faschingbauer M, Sgroi M et al (2014) Can the tibial slope be measured on lateral knee radiographs? Knee Surg Sports Traumatol Arthrosc 22:3163–3167CrossRefPubMed Faschingbauer M, Sgroi M et al (2014) Can the tibial slope be measured on lateral knee radiographs? Knee Surg Sports Traumatol Arthrosc 22:3163–3167CrossRefPubMed
11.
Zurück zum Zitat Gwinner C, Weiler A et al (2017) Tibial slope strongly influences knee stability after posterior cruciate ligament reconstruction: a prospective 5- to 15-year follow-up. Am J Sports Med 2:355–361CrossRef Gwinner C, Weiler A et al (2017) Tibial slope strongly influences knee stability after posterior cruciate ligament reconstruction: a prospective 5- to 15-year follow-up. Am J Sports Med 2:355–361CrossRef
12.
Zurück zum Zitat Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86-A:506–511CrossRefPubMed Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86-A:506–511CrossRefPubMed
13.
Zurück zum Zitat Hoffman AA, Bachus KN et al (1991) Effect of the tibial cut on subsidence following total knee arthroplasty. Clin Orthop Relat Res 269:63–69 Hoffman AA, Bachus KN et al (1991) Effect of the tibial cut on subsidence following total knee arthroplasty. Clin Orthop Relat Res 269:63–69
14.
15.
Zurück zum Zitat Iversen BF, Stürup J et al (1989) Implications of muscular defense in testing for the anterior drawer sign in the knee. Am J Sports Med 17:409–413CrossRefPubMed Iversen BF, Stürup J et al (1989) Implications of muscular defense in testing for the anterior drawer sign in the knee. Am J Sports Med 17:409–413CrossRefPubMed
16.
Zurück zum Zitat Jacobsen K (1976) Stress radiographical measurement of the anteroposterior, medial and lateral stability of the knee joint. Acta Orthop Scand 47:335–344CrossRefPubMed Jacobsen K (1976) Stress radiographical measurement of the anteroposterior, medial and lateral stability of the knee joint. Acta Orthop Scand 47:335–344CrossRefPubMed
17.
Zurück zum Zitat Jojima H, Whiteside LA, Ogata K (2004) Effect of tibial slope or posterior cruciate ligament release on knee kinematics. Clin Orthop Relat Res 426:194–198CrossRef Jojima H, Whiteside LA, Ogata K (2004) Effect of tibial slope or posterior cruciate ligament release on knee kinematics. Clin Orthop Relat Res 426:194–198CrossRef
18.
Zurück zum Zitat Jung TM, Reinhardt C et al (2006) Stress radiography to measure posterior cruciate ligament insufficiency: a comparison of five different techniques. Knee Surg Sports Traumatol Arthrosc 14:1116–1121CrossRefPubMed Jung TM, Reinhardt C et al (2006) Stress radiography to measure posterior cruciate ligament insufficiency: a comparison of five different techniques. Knee Surg Sports Traumatol Arthrosc 14:1116–1121CrossRefPubMed
19.
Zurück zum Zitat Kessler MA, Burkart A et al (2003) Development of a 3-dimensional method to determine the tibial slope with multislice-CT. Z Orthop Ihre Grenzgeb 141:143–147CrossRefPubMed Kessler MA, Burkart A et al (2003) Development of a 3-dimensional method to determine the tibial slope with multislice-CT. Z Orthop Ihre Grenzgeb 141:143–147CrossRefPubMed
20.
Zurück zum Zitat Lee DH, Park SC et al (2016) Effect of soft tissue laxity of the knee joint on limb alignment correction in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 24:3704–3712CrossRefPubMed Lee DH, Park SC et al (2016) Effect of soft tissue laxity of the knee joint on limb alignment correction in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 24:3704–3712CrossRefPubMed
21.
Zurück zum Zitat Lee SY, Lim HC et al (2017) Sagittal osteotomy inclination in medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 25:823–831CrossRefPubMed Lee SY, Lim HC et al (2017) Sagittal osteotomy inclination in medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 25:823–831CrossRefPubMed
22.
Zurück zum Zitat Li Y, Hong L et al (2014) Are failures of anterior cruciate ligament reconstruction associated with steep posterior tibial slopes? A case control study. Chin Med J (Engl) 127:2649–2653 Li Y, Hong L et al (2014) Are failures of anterior cruciate ligament reconstruction associated with steep posterior tibial slopes? A case control study. Chin Med J (Engl) 127:2649–2653
23.
Zurück zum Zitat Lu H, Mow CS, Lin J (1999) Total knee arthroplasty in the presence of severe flexion contracture: a report of 37 cases. J Arthroplasty 14:775–780CrossRefPubMed Lu H, Mow CS, Lin J (1999) Total knee arthroplasty in the presence of severe flexion contracture: a report of 37 cases. J Arthroplasty 14:775–780CrossRefPubMed
24.
Zurück zum Zitat Moore TM, Harvey JP (1974) Roentgenographic measurement of tibial-plateau depression due to fracture. J Bone Joint Surg Am 56:155–160CrossRefPubMed Moore TM, Harvey JP (1974) Roentgenographic measurement of tibial-plateau depression due to fracture. J Bone Joint Surg Am 56:155–160CrossRefPubMed
25.
Zurück zum Zitat Morberg P, Chapman-Sheath P et al (2002) The function of the posterior cruciate ligament in an anteroposterior-gliding rotating platform total knee arthroplasty. J Arthroplasty 17:484–489CrossRefPubMed Morberg P, Chapman-Sheath P et al (2002) The function of the posterior cruciate ligament in an anteroposterior-gliding rotating platform total knee arthroplasty. J Arthroplasty 17:484–489CrossRefPubMed
26.
Zurück zum Zitat Murao T, Ochi M et al (1997) The adverse effects of sectioning the posterior cruciate ligament in rabbits. Changes in the structural and morphological properties of the femur-anterior cruciate ligament-tibia complex. Arch Orthop Trauma Surg 116:1–5CrossRefPubMed Murao T, Ochi M et al (1997) The adverse effects of sectioning the posterior cruciate ligament in rabbits. Changes in the structural and morphological properties of the femur-anterior cruciate ligament-tibia complex. Arch Orthop Trauma Surg 116:1–5CrossRefPubMed
27.
Zurück zum Zitat Nunley RM, Nam D et al (2014) Extreme variability in posterior slope of the proximal tibia: measurements on 2395 CT scans of patients undergoing UKA? J Arthroplasty 29:1677–1680CrossRefPubMedPubMedCentral Nunley RM, Nam D et al (2014) Extreme variability in posterior slope of the proximal tibia: measurements on 2395 CT scans of patients undergoing UKA? J Arthroplasty 29:1677–1680CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Ochi M, Murao T et al (1999) Isolated posterior cruciate ligament insufficiency induces morphological changes of anterior cruciate ligament collagen fibrils. Arthroscopy 15:292–296CrossRefPubMed Ochi M, Murao T et al (1999) Isolated posterior cruciate ligament insufficiency induces morphological changes of anterior cruciate ligament collagen fibrils. Arthroscopy 15:292–296CrossRefPubMed
29.
Zurück zum Zitat Ozel O, Yucel B et al (2017) Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc 25:314–318CrossRefPubMed Ozel O, Yucel B et al (2017) Changes in posterior tibial slope angle in patients undergoing open-wedge high tibial osteotomy for varus gonarthrosis. Knee Surg Sports Traumatol Arthrosc 25:314–318CrossRefPubMed
30.
Zurück zum Zitat Pagnano MW, Cushner FD, Scott NW (1998) Role of the posterior cruciate ligament in total knee arthroplasty. J Am Acad Orthop Surg 6:176–187CrossRefPubMed Pagnano MW, Cushner FD, Scott NW (1998) Role of the posterior cruciate ligament in total knee arthroplasty. J Am Acad Orthop Surg 6:176–187CrossRefPubMed
31.
Zurück zum Zitat Roux W (1905) Die Entwicklungsmechanik; ein neuer Zweig der biologischen Wissenschaft, vols I & II. Ed. Wilhelm Engelmann, Leipzig Roux W (1905) Die Entwicklungsmechanik; ein neuer Zweig der biologischen Wissenschaft, vols I & II. Ed. Wilhelm Engelmann, Leipzig
32.
Zurück zum Zitat Schulz MS, Russe K et al (2005) Reliability of stress radiography for evaluation of posterior knee laxity. Am J Sports Med 33:502–506CrossRefPubMed Schulz MS, Russe K et al (2005) Reliability of stress radiography for evaluation of posterior knee laxity. Am J Sports Med 33:502–506CrossRefPubMed
33.
Zurück zum Zitat Schulz MS, Steenlage ES et al (2007) Distribution of posterior tibial displacement in knees with posterior cruciate ligament tears. J Bone Joint Surg Am 89:332–338CrossRefPubMed Schulz MS, Steenlage ES et al (2007) Distribution of posterior tibial displacement in knees with posterior cruciate ligament tears. J Bone Joint Surg Am 89:332–338CrossRefPubMed
34.
Zurück zum Zitat Scott RD, Chmell MJ (2008) Balancing the posterior cruciate ligament during cruciate-retaining fixed and mobile-bearing total knee arthroplasty: description of the pull-out lift-off and slide-back tests. J Arthroplasty 23:605–608CrossRefPubMed Scott RD, Chmell MJ (2008) Balancing the posterior cruciate ligament during cruciate-retaining fixed and mobile-bearing total knee arthroplasty: description of the pull-out lift-off and slide-back tests. J Arthroplasty 23:605–608CrossRefPubMed
35.
Zurück zum Zitat Sekiya JK, West RV et al (2005) Clinical outcomes after isolated arthroscopic single-bundle posterior cruciate ligament reconstruction. Arthroscopy 21:1042–1050CrossRefPubMed Sekiya JK, West RV et al (2005) Clinical outcomes after isolated arthroscopic single-bundle posterior cruciate ligament reconstruction. Arthroscopy 21:1042–1050CrossRefPubMed
36.
Zurück zum Zitat Shoemaker SC, Markolf KL (1986) The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision. J Bone Joint Surg Am 68:71–79CrossRefPubMed Shoemaker SC, Markolf KL (1986) The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision. J Bone Joint Surg Am 68:71–79CrossRefPubMed
37.
Zurück zum Zitat Sing G, Tan JH et al (2013) Restoring the anatomical tibial slope and limb axis may maximise post-operative flexion in posterior-stabilised total knee replacements. Bone Joint J 10:1354–1358CrossRef Sing G, Tan JH et al (2013) Restoring the anatomical tibial slope and limb axis may maximise post-operative flexion in posterior-stabilised total knee replacements. Bone Joint J 10:1354–1358CrossRef
38.
Zurück zum Zitat Song EK, Park HW et al (2014) Transtibial versus tibial inlay techniques for posterior cruciate ligament reconstruction: long-term follow-up study. Am J Sports Med 42:2964–2971CrossRefPubMed Song EK, Park HW et al (2014) Transtibial versus tibial inlay techniques for posterior cruciate ligament reconstruction: long-term follow-up study. Am J Sports Med 42:2964–2971CrossRefPubMed
39.
Zurück zum Zitat Swany MR, Scott RD (1993) Posterior polyethylene wear in posterior cruciate ligament-retaining total knee arthroplasty: a case study. J Arthroplasty 8:439–446CrossRefPubMed Swany MR, Scott RD (1993) Posterior polyethylene wear in posterior cruciate ligament-retaining total knee arthroplasty: a case study. J Arthroplasty 8:439–446CrossRefPubMed
40.
Zurück zum Zitat Torzilli PA, Deng X, Warren RF (1994) The effect of joint-compressive load and quadriceps muscle force on knee motion in the intact and anterior cruciate ligament-sectioned knee. Am J Sports Med 22:105–112CrossRefPubMed Torzilli PA, Deng X, Warren RF (1994) The effect of joint-compressive load and quadriceps muscle force on knee motion in the intact and anterior cruciate ligament-sectioned knee. Am J Sports Med 22:105–112CrossRefPubMed
41.
Zurück zum Zitat Webb JM, Salmon LJ et al (2013) Posterior tibial slope and further anterior cruciate ligament injuries in the anterior cruciate ligament-reconstructed patient. Am J Sports Med 41:2800–2804CrossRefPubMed Webb JM, Salmon LJ et al (2013) Posterior tibial slope and further anterior cruciate ligament injuries in the anterior cruciate ligament-reconstructed patient. Am J Sports Med 41:2800–2804CrossRefPubMed
42.
Zurück zum Zitat Wordeman SC, Quatman CE et al (2012) In vivo evidence for tibial plateau slope as a risk factor for anterior cruciate ligament injury: a systematic review and meta-analysis. Am J Sports Med 40:1673–1681CrossRefPubMedPubMedCentral Wordeman SC, Quatman CE et al (2012) In vivo evidence for tibial plateau slope as a risk factor for anterior cruciate ligament injury: a systematic review and meta-analysis. Am J Sports Med 40:1673–1681CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Yang JH, Yoon JR et al (2012) Second-look arthroscopic assessment of arthroscopic single-bundle posterior cruciate ligament reconstruction: comparison of mixed graft versus achilles tendon allograft. Am J Sports Med 40:2052–2060CrossRefPubMed Yang JH, Yoon JR et al (2012) Second-look arthroscopic assessment of arthroscopic single-bundle posterior cruciate ligament reconstruction: comparison of mixed graft versus achilles tendon allograft. Am J Sports Med 40:2052–2060CrossRefPubMed
44.
Zurück zum Zitat Yoshida S, Matsui N et al (2005) In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions. J Arthroplasty 20:777–783CrossRef Yoshida S, Matsui N et al (2005) In vivo kinematic comparison of posterior cruciate-retaining and posterior stabilized total knee arthroplasties under passive and weight-bearing conditions. J Arthroplasty 20:777–783CrossRef
Metadaten
Titel
High tibial slope correlates with increased posterior tibial translation in healthy knees
verfasst von
Imke Schatka
Andreas Weiler
Tobias M. Jung
Thula C. Walter
Clemens Gwinner
Publikationsdatum
09.09.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 9/2018
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4706-4

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